What is Conjunctival Hemorrhage?

A conjunctival haemorrhage, also known as a subconjunctival haemorrhage, is a condition that can be alarming to witness but is generally benign. This condition occurs when a small blood vessel breaks just beneath the surface of the eye, resulting in a noticeable red or dark patch on the white part of the eye (sclera).

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Causes of Conjunctival Hemorrhage

Understanding the causes of conjunctival hemorrhage can help in managing and preventing this condition. The primary causes include:

Physical Trauma

One of the most common causes of conjunctival haemorrhage is physical trauma to the eye. This can result from minor injuries, such as rubbing the eye too hard, or more severe trauma, such as a direct blow to the eye.

Sudden Increases in Blood Pressure

Sudden increases in blood pressure due to activities like heavy lifting, coughing, sneezing, or even intense laughter can cause a blood vessel in the eye to burst, leading to a haemorrhage.

Medical Conditions

Certain medical conditions can predispose individuals to conjunctival hemorrhage. These include hypertension, diabetes, and blood clotting disorders. Individuals on blood-thinning medications are also at an increased risk.

Eye Surgery

Surgeries involving the eye, such as LASIK or cataract surgery, can sometimes result in subconjunctival haemorrhage as a postoperative complication.

Straining

Straining activities, such as lifting heavy objects, constipation, or childbirth, can cause a sudden increase in venous pressure, leading to a burst of blood vessels in the eye.

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Symptoms of Conjunctival Hemorrhage

A conjunctival hemorrhage is usually painless and does not affect vision. The primary symptom is the appearance of a bright red or dark patch on the sclera. Other symptoms may include:

Redness

The most noticeable symptom is a bright red spot on the white part of the eye. This redness is due to blood leaking from the broken blood vessel.

Mild Irritation

Although generally painless, some individuals may experience mild irritation or a feeling of fullness in the eye.

No Visual Impairment

Conjunctival hemorrhage does not affect vision. However, if you experience any changes in vision, it is crucial to seek medical attention, as they may indicate a more serious condition.

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Risk Factors for Developing Conjunctival Hemorrhage

Certain factors can increase the likelihood of developing a conjunctival hemorrhage. Understanding these risk factors can help in managing and preventing the condition.

Age

Older adults are more susceptible to conjunctival hemorrhage due to the increased fragility of blood vessels with age.

Hypertension

High blood pressure is a significant risk factor. Managing blood pressure through medication, diet, and exercise can reduce the risk.

Diabetes

Individuals with diabetes are at a higher risk due to potential blood vessel damage associated with the condition.

Blood Thinners

Medications that thin the blood can increase the risk of bleeding, including in the eyes.

Physical Strain

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Engaging in activities that involve heavy lifting, intense coughing, or vomiting can lead to a sudden increase in venous pressure, which can cause a blood vessel to burst.

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Diagnosis of Conjunctival Hemorrhage

Diagnosing a conjunctival hemorrhage typically involves a physical examination of the eye. A healthcare provider may use the following methods:

Visual Inspection

A simple visual inspection is often sufficient to diagnose a conjunctival hemorrhage. The characteristic red patch on the sclera is usually unmistakable.

Medical History

A review of the patient's medical history can help identify potential underlying causes, such as hypertension or a bleeding disorder.

Additional Tests

In some cases, additional tests may be warranted to rule out other potential causes of eye redness, particularly if the bleeding recurs or is associated with different symptoms. These tests may include blood pressure measurements, blood tests, or imaging studies.

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Treatment Options for Conjunctival Hemorrhage

Observation

Most cases of conjunctival hemorrhage resolve on their own without the need for medical intervention. The blood is gradually absorbed by the body, and the red spot typically disappears within one to two weeks.

Artificial Tears

If the eye feels irritated, artificial tears or lubricating eye drops can provide relief. These products help keep the eye moist and reduce discomfort.

Addressing Underlying Conditions

If an underlying condition, such as hypertension or a bleeding disorder, is identified, treating that condition can help prevent future episodes of conjunctival hemorrhage. This may involve medication, lifestyle changes, or other medical interventions.

Avoiding Blood Thinners

If you are taking blood-thinning medications, your healthcare provider may suggest adjusting your dosage or switching to an alternative medication to reduce the risk of recurrent hemorrhages. However, do not make any changes to your medication regimen without consulting your doctor.

When to Seek Medical Attention

While conjunctival hemorrhage is generally harmless, there are situations where medical attention is necessary:

Persistent Symptoms

If the red spot does not begin to fade after two weeks or recurs frequently, seek medical advice to rule out underlying conditions.

Pain or Vision Changes

If you experience pain or changes in vision, or if the bleeding is accompanied by other symptoms such as headache or dizziness, consult a healthcare provider immediately.

Large Area of Hemorrhage

A large area of bleeding may indicate a more severe condition and warrants a thorough medical evaluation.