Subconjunctival Hemorrhage: Causes and Treatments
A subconjunctival hemorrhage occurs when a small blood vessel breaks just beneath the conjunctiva, the clear surface that covers the white part of the eye (sclera). Although it may appear serious, this condition is typically benign.
The conjunctiva contains numerous tiny blood vessels that can rupture, leading to a localized collection of blood. Despite its appearance, a subconjunctival hemorrhage usually does not cause pain or affect vision.
Causes of Subconjunctival Hemorrhage
Common Causes
Several factors can contribute to the rupture of blood vessels in the eye:
- Trauma: Physical injury or trauma to the eye can lead to a subconjunctival hemorrhage. This includes rubbing the eye vigorously or an accidental impact.
- Sudden Increases in Blood Pressure: Activities that cause a sudden spike in blood pressure, such as heavy lifting, coughing, sneezing, or vomiting, can cause blood vessels to burst.
- Medical Conditions: Certain medical conditions, such as hypertension or diabetes, can weaken blood vessels, making them more susceptible to rupture.
- Medications: Blood-thinning medications and anticoagulants can increase the likelihood of bleeding, including in the eyes.
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Get A Second OpinionRare Causes
Less commonly, a subconjunctival hemorrhage may be associated with more serious conditions:
- Blood Clotting Disorders: Conditions that affect blood clotting can increase the risk of hemorrhage.
- Eye Surgery: Post-operative complications from eye surgery can sometimes result in a subconjunctival hemorrhage.
- Infections: Severe eye infections, although rare, can lead to bleeding beneath the conjunctiva.
Symptoms and Diagnosis
The primary symptom of a subconjunctival hemorrhage is a visible red patch on the sclera. Unlike other forms of bleeding, this condition is usually painless and does not cause discharge or changes in vision. The red patch may vary in size, and it can appear in one or both eyes.
Diagnosis
Diagnosis of a subconjunctival hemorrhage is generally straightforward and can be made through a visual examination by a healthcare professional. However, if the hemorrhage is recurrent or associated with other symptoms, further evaluation may be necessary to rule out underlying conditions. This could include blood tests, blood pressure monitoring, or imaging studies.
Types of Subconjunctival Hemorrhage
Subconjunctival hemorrhages can be classified based on their cause and severity:
- Spontaneous Hemorrhage: Occurs without any apparent cause, often associated with minor increases in blood pressure or minor eye strain.
- Traumatic Hemorrhage: Directly results from physical trauma or injury to the eye.
- Recurrent Hemorrhage: Multiple instances of hemorrhage, potentially indicating an underlying systemic issue such as hypertension or a bleeding disorder.
Treatment Options
Observation and Time
In most cases, no specific treatment is required for a subconjunctival hemorrhage. The condition typically resolves on its own within one to two weeks. The blood is gradually absorbed by the body, and the red patch will fade.
Eye Drops and Lubricants
While treatment is often unnecessary, over-the-counter artificial tears or lubricating eye drops can provide comfort if there is mild irritation. These drops do not speed up healing but can help alleviate dryness and discomfort.
Medical Intervention
In rare instances where the hemorrhage is caused by an underlying condition, treating that condition is crucial. For example, managing hypertension or adjusting medications may be necessary. If an infection is present, appropriate antibiotic or antiviral treatments will be prescribed.
Prevention Strategies
Protecting the Eyes
Preventing trauma to the eyes is one of the most effective ways to reduce the risk of subconjunctival hemorrhage. This includes wearing protective eyewear during activities that pose a risk of injury.
Managing Health Conditions
Proper management of systemic conditions such as hypertension and diabetes is essential in preventing recurrent hemorrhages. Regular check-ups and adherence to prescribed treatments can help maintain overall vascular health.
Avoiding Strain
Avoiding activities that cause sudden increases in blood pressure can also help prevent hemorrhages. This includes practicing gentle techniques when lifting heavy objects and managing chronic coughing or sneezing through appropriate medical care.
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Book an AppointmentSpecial Considerations: Subconjunctival Hemorrhage in Newborns
Causes in Newborns
Subconjunctival hemorrhages can occur in newborns, typically as a result of the birthing process. The pressure exerted on the baby during delivery can cause small blood vessels in the eye to rupture. This condition is generally harmless and resolves without intervention.
Treatment and Monitoring
In newborns, a subconjunctival hemorrhage does not usually require treatment. However, it is important for healthcare providers to monitor the baby to ensure that there are no other associated complications. Parents should be reassured that the condition is temporary and does not affect the baby’s vision.
When to Seek Medical Attention
Although a subconjunctival hemorrhage is usually benign, certain signs warrant medical evaluation:
- Recurrent Hemorrhages: Frequent occurrences may indicate an underlying health issue that needs to be addressed.
- Associated Symptoms: If the hemorrhage is accompanied by pain, vision changes, or discharge, a more serious condition may be present.
- Persistent Redness: If the red patch does not begin to fade after two weeks, or if it worsens, medical advice should be sought.
Frequently Asked Questions
1. What are the symptoms of subconjunctival hemorrhage?
Symptoms include a bright red patch on the white part of the eye, but there is usually no pain or change in vision.
2. What causes subconjunctival hemorrhage?
It is caused by the rupture of tiny blood vessels under the conjunctiva, often due to trauma, sneezing, coughing, or high blood pressure.
3. How is subconjunctival hemorrhage treated?
No specific treatment is needed; it usually resolves on its own in 1-2 weeks. Eye drops may help relieve irritation.
4. How is subconjunctival hemorrhage diagnosed?
Diagnosis is made through a physical eye exam, and in some cases, blood pressure checks or blood tests to rule out underlying conditions.
5. Can newborns have subconjunctival hemorrhage?
Yes, subconjunctival hemorrhage can occur in newborns due to pressure during delivery, but it is usually harmless and heals on its own.
