A subconjunctival hemorrhage (sub-kun-JUNK-tih-vul HEM-uh-ruj) occurs when a tiny blood vessel breaks just underneath the clear surface of your eye (conjunctiva).

You may not realize you have a subconjunctival hemorrhage until you look in the mirror and find the white part of your eye is bright red.

The conjunctiva can't absorb the blood very quickly, so the blood is trapped under this transparent surface. A subconjunctival hemorrhage may worry you, but it's usually a harmless condition that disappears within one or two weeks.

Subconjunctival hemorrhage often occurs without any obvious harm to your eye, or it may be the result of a strong sneeze or cough that caused a blood vessel to break. You don't need any specific treatment for a subconjunctival hemorrhage.

The most obvious sign of a subconjunctival hemorrhage is a bright red patch on the white (sclera) of your eye.

Despite its bloody appearance, a subconjunctival hemorrhage should cause no change in your vision, no discharge from your eye and no pain. Your only discomfort may be a scratchy feeling on the surface of your eye.

When to see a doctor

If you have recurrent subconjunctival hemorrhages or other bleeding, talk to your doctor.

The cause of subconjunctival hemorrhage isn't always known. However, the following actions may cause a small blood vessel to rupture in your eye:

  • Violent coughing
  • Powerful sneezing
  • Heavy lifting
  • Vomiting

In some cases, subconjunctival hemorrhage may result from an eye injury, such as from:

  • Roughly rubbing your eye
  • Severe eye infection
  • Trauma, such as a foreign object injuring your eye

Risk factors for subconjunctival hemorrhage include:

  • Diabetes
  • High blood pressure (hypertension)
  • Certain blood-thinning medications, such as warfarin (Coumadin) and aspirin
  • Blood-clotting disorders

Although you may feel self-conscious about the appearance of your eye, health complications from a subconjunctival hemorrhage are rare. If your condition is due to trauma, your doctor may evaluate your eye to ensure you don't have other eye complications or injury.

You're likely to start by seeing your family doctor or a general practitioner. However, in some cases when you call to set up an appointment, you may be referred immediately to an eye doctor (ophthalmologist).

Because appointments can be brief, and because there's often a lot to discuss, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including any major stresses or recent life changes.
  • Bring a list of all medications, vitamins or supplements that you're taking.
  • Write down questions to askyour doctor.

Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For subconjunctival hemorrhage, some basic questions to ask your doctor include:

  • What has likely caused this problem?
  • Other than the most likely cause, what are other possible causes for my symptoms?
  • What kinds of tests do I need?
  • Is my condition likely temporary or chronic?
  • What is the best course of action?
  • What are the alternatives to the primary approach that you're suggesting?
  • I have these other health conditions. How can I best manage them together?
  • Are there any restrictions that I need to follow?
  • Should I see a specialist?
  • Are there any brochures or other printed material that I can take home with me? Do you recommend that I visit a website related to this problem?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:

  • When did you first notice the problem?
  • Do you have any symptoms associated with this?

Your doctor or eye doctor (ophthalmologist) will generally diagnose subconjunctival hemorrhage by looking at your eye. You'll likely need no other tests.

However, your doctor may ask you some questions about your general health and symptoms, conduct an eye examination, take your blood pressure, and obtain a routine blood test to make sure you don't have a potentially serious bleeding disorder.

You may want to use eyedrops, such as artificial tears, to soothe any scratchy feeling you have in your eye.

Beyond that, the blood in your eye will absorb within about one to two weeks, and you'll need no treatment.

There's no known way to prevent subconjunctival hemorrhage unless there is a clearly identifiable cause for the bleeding, such as might occur if you're taking blood-thinning medications or if you have a bleeding disorder.

If you need to rub your eyes, rub your eyes gently. Rubbing your eyes too hard can cause minor trauma to your eyes.

Jan. 22, 2014