Subconjunctival haemorrhage is a harmless eye condition and ranks among the most frequent causes of sudden eye redness. In younger individuals, it is often linked to eye trauma or the use of contact lenses. Among older adults, underlying systemic issues such as high blood pressure, diabetes, or hardening of the arteries are commonly associated. 

If the haemorrhage occurs repeatedly or does not resolve over time, a thorough medical evaluation is recommended. This may include checking for high blood pressure, clotting issues, possible tumours in or around the eye, and adverse reactions to medications.

Students who are going to appear for the NEET PG exam must have precise knowledge of the causes, risk factors, and treatment of subconjunctival haemorrhage. This will not only help cover their syllabus but also assist in making sound clinical decisions. 

Read further for detailed insight!

What is a Subconjunctival Haemorrhage?

If a bright red patch suddenly appears on the white part of the eye, it is most likely a subconjunctival haemorrhage—a harmless condition despite its alarming appearance. This occurs when a tiny blood vessel beneath the conjunctiva, the transparent membrane that covers the sclera (white of the eye) and lines the inner eyelids, ruptures and leaks blood. 

It has lots of small blood vessels that are prone to bursting. When a small vessel bursts, it leaks blood under the conjunctiva and forms a shiny red spot on the white of your eye. Since the blood is trapped beneath the conjunctiva, it remains intact and cannot be removed. The good news is that the bleeding does not reach the cornea or the interior of the eye, and sight remains unaffected.

Although the red spot from a subconjunctival haemorrhage is intimidating in appearance, it is not accompanied by any other symptoms and will resolve without treatment in a matter of weeks.

What are the Subconjunctival Haemorrhage Symptoms?

The sole clinical indication of eye haemorrhage in the majority of instances is a red patch on the eye. It does not cause pain, swelling, or vision problems. 

Many people remain unaware of the condition until they notice the redness in a mirror or someone else points it out to them. Some individuals may experience slight irritation, but typically, there is no discharge or other noticeable symptoms.

What are the Causes of Subconjunctival Haemorrhage?

Subconjunctival haemorrhages most often occur when blood pressure suddenly increases due to:

• Severe sneezing
• Straining with movement of the bowels
• Forceful coughing
• Vomiting

Other reasons are:

• Rubbing the eye roughly
• Injuries such as having a foreign object in the eye
• Contact lens use
• Viral infections
• Recent eye surgery

Less common reasons may be:

• Diabetes
• High blood pressure
• Blood-thinning medications like aspirin or warfarin (Coumadin)
• Disorders affecting blood clotting

The risk of contracting this condition rises with age, particularly above the age of 50, by virtue of a higher likelihood of coexisting medical conditions like hypertension and diabetes.

What are the Potential Risk Factors for Subconjunctival Haemorrhage?

Certain risk factors enhance the likelihood of contracting a subconjunctival haemorrhage:

• Age: Individuals above 65 years of age are at increased risk of contracting this condition, particularly if they have vascular complications like hypertension or diabetes.
• Contact Lens Users: Contact lens wearers are at risk of developing problems in their conjunctiva, such as dryness and irritation, which can result in inflammation and blood vessel rupture.
• Eye Surgery: People who have had eye surgeries, including cataract surgery, are also at risk for subconjunctival haemorrhages.

How to Diagnose Subconjunctival Haemorrhage?

Physicians can diagnose a subconjunctival haemorrhage simply by examining the eye. They will ask about general health and the history of any recent trauma. It may involve checking blood pressure and a slit lamp examination—a type of eye examination using a microscope.

In some instances, blood tests must be conducted in order to eliminate severe bleeding disorders. If the diagnosis appears as “subconjunctival haemorrhage ICD-10” on medical documents, this refers only to the standardised coding system used for billing and does not change the diagnosis itself.

What is Subconjunctival Haemorrhage Treatment?

Subconjunctival haemorrhage treatment is generally not required in most cases, as the condition tends to heal on its own. However, if your eye becomes itchy or irritated, artificial tears or lubricating drops can help ease the discomfort. Most of the broken vessels in the eye heal within two weeks, but major haemorrhages might take a little longer to heal. 

During the healing process, the red area may change colour, much like a bruise, fading from red to yellowish as the blood is absorbed. You should go to the doctor if you’re experiencing pain in your eye, as this can be a sign of a condition such as a hyphema bleeding in front of the iris (the coloured part of your eye). 

Also, if you find that subconjunctival haemorrhages occur repeatedly, your doctor will order tests to identify the underlying cause. Certain blood clotting disorders, like haemophilia or von Willebrand disease, can increase the likelihood of repeated subconjunctival haemorrhages.

FAQs About Subconjunctival Haemorrhage

1. How long does a subconjunctival haemorrhage last?

A subconjunctival haemorrhage usually develops suddenly after activities like sneezing, coughing, or straining. Although it may look alarming, it is generally harmless and resolves on its own within about two weeks without any specific treatment.

2. How can you assist in healing a subconjunctival haemorrhage more quickly?

Even though it is not possible to speed up the healing process, artificial tear application can relieve any scratchiness or irritation in the eye. The blood will gradually get absorbed over one to two weeks.

3. How do you know a subconjunctival haemorrhage is healing?

Healing is noticed when the red spot on the eye starts to pale and transform colour, tending to turn yellow or brownish before totally vanishing. Vision will be unaffected in any manner.

4. Is sleeping beneficial for subconjunctival haemorrhage?

Subconjunctival haemorrhages are not the result of insufficient sleep but of bursts of pressure from such activities as sneezing or coughing. However, inadequate sleep can cause eye strain and dryness, potentially making the eyes more vulnerable.

5. What should you avoid if you have a subconjunctival haemorrhage?

Avoid worsening the condition by refraining from activities that strain the eyes or elevate blood pressure, such as heavy lifting or strenuous exercise. If you notice that you are consistently experiencing these haemorrhages, make sure to check your blood pressure and discuss proper management with your doctor.

Conclusion

A subconjunctival haemorrhage will generally settle down by itself without producing any eyesight issues. It can recur in approximately 10% of patients, particularly those on blood-thinning medications. The eye can be sore or scratchy, and over-the-counter artificial tears can help alleviate the discomfort. A cold compress may also help relieve the pain.

For each NEET PG candidate, subconjunctival haemorrhage is a must-know. DocTutorials provides concise video lectures, fast revision programmes, and high-yield notes specifically designed to suit your exam preparation and future practice as a medical doctor. Join DocTutorials’ NEET PG courses today and take your medical preparation to the next level!