Subconjunctival Hemorrhage

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Medical Author:

Andrew A. Dahl, MD, FACS

Andrew A. Dahl, MD, FACS

Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.

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Medical Editor:

Jerry R. Balentine, DO, FACEP

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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The conjunctiva is a clear tissue that covers the white of the eye (the sclera) and lines the inside of both eyelids. A subconjunctival hemorrhage is blood that is located between the conjunctiva and the underlying sclera.

The conjunctiva contains nerves and many small blood vessels. These blood vessels are usually barely visible but become larger and more visible if the eye is inflamed. These blood vessels are somewhat fragile and their walls may break easily, resulting in a subconjunctival hemorrhage (bleeding under the conjunctiva). A subconjunctival hemorrhage appears as a bright red or dark red patch on the sclera. Most subconjunctival hemorrhages are spontaneous without an obvious cause for the bleeding from normal conjunctival blood vessels. Since most subconjunctival hemorrhages are painless, a person may discover a subconjunctival hemorrhage only by looking in the mirror. Many spontaneous subconjunctival hemorrhages are first noticed by another person seeing a red spot on the white of your eye. Rarely there may be an abnormally large or angulated blood vessel as the source of the hemorrhage.

The following can occasionally result in a spontaneous subconjunctival hemorrhage:

• Sneezing



• Coughing



• Straining/vomiting



• Increasing the pressure in the veins of the head, as in weight lifting



• Eye rubbing or inserting contact lenses



• Certain infections of the outside of the eye (conjunctivitis) where a virus or a bacteria weaken the walls of small blood vessels under the conjunctiva



• Medical disorder causing bleeding or inhibiting normal clotting.

Subconjunctival hemorrhage can also be non-spontaneous and result from a severe eye infection, trauma to the head or eye or after eye or eyelid surgery.