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What is a Subconjunctival Hematoma?

D. Jeffress
D. Jeffress

A subconjunctival hematoma is a visible collection of blood in the eye that results from a broken blood vessel. It specifically occurs in the subconjunctival space along the white of the eye, underneath the conjunctiva layer. Most subconjunctival hematomas are painless and do not disrupt vision. They usually go away in about two weeks without any special type of self-care or medical treatment. A hematoma that persists for longer than two weeks or recurs frequently may be a sign of an underlying health problem and should be evaluated by a doctor.

The blood vessels in the subconjunctival space are relatively delicate. They can break open and leak blood for a number of different reasons. A subconjunctival hematoma can arise after a forceful sneeze, a cough, a bout of vomiting, or a mild eye injury. Sometimes, simply rubbing an itchy eye is enough to break a blood vessel. Other potential causes and risk factors include high blood pressure, diabetes, anemia, and eye surgery.

Subconjunctival hematoma is a visible collection of blood in the eye.
Subconjunctival hematoma is a visible collection of blood in the eye.

Unless the hematoma is caused by an eye injury, it is likely to be entirely painless. A bright red spot appears on the white of the eye and spreads out as more blood is spilled. Since the blood vessel breakage is under the outer membrane of the eye, the pool of blood cannot be flushed out with water or dabbed with a tissue.

Most hematomas grow large in the first one or two days and slowly shrink away in one or two weeks. Like a skin bruise, a subconjunctival hematoma only lasts as long as it takes for underlying tissue to absorb all of the escaped blood. The spot typically gets lighter in color during the healing phase, changing from a bright red to a yellow-orange tint. After the two week mark, the white of the eye is usually back to normal.

A subconjunctival hematoma can arise after a forceful sneeze.
A subconjunctival hematoma can arise after a forceful sneeze.

It is important to visit an eye doctor if a subconjunctival hematoma is accompanied by vision disturbances, pain, or bleeding in other parts of the body. Medical care is also needed if hematomas appear in both eyes at once or if the red spot fails to fade away after a couple weeks. The ophthalmologist can examine the eye and run other tests as necessary to determine the underlying cause. A patient with pain may be prescribed soothing artificial tears or anti-inflammatory medications. Other issues such as high blood pressure and diabetes are treated appropriately with medications.

Discussion Comments

seHiro

@Hawthorne - If you use makeup to cover up the dark circles, it sounds like you've had them for awhile. I doubt they and the broken blood vessel in the eye are related, but it sounds like you should see a doctor about the eye bags even if you don't feel sick. Dark circles under the eyes can mean a wide variety of ailments, including serious vitamin deficiencies and intestinal parasites.

The blood in your eye isn't likely from any underlying disease or terrible condition. You remember rubbing the eye when it felt itchy, so it's almost certainly that incident that caused it to bloom into a subconjunctival hematoma.

Itchy eyes might be a symptom from allergies, though -- might want to ask the doctor about those while seeing him about the dark circles under your eyes. Whatever you do, I wish you the best of luck, and good health.

Hawthorne

Okay, good, so the red spot on my eye will go away on its own, then. I think I got it from rubbing too hard when my eyes were itchy. Now if I could just figure out how to get rid of dark circles underneath the red I wouldn't look so ghastly. I use makeup to cover the circles up, usually, because people stare. I don't feel sickly, but my eyes are all baggy and now have bleeding in them -- what gives?

Is there any condition that causes dark circles under the eyes and eye itchiness bad enough to rub and make them bleed? Are these two things connected at all? I tend to assume they are just because they're both eye-related, but I guess since the bleeding eye problem can happen on its own, they could be separate.

malmal

@hanley79 - I got the same bleeding eye look right after I got eye surgery. It freaked my family (and me) out at first, because we thought something had gone wrong with the procedure and that my vision was at risk. We panicked and drove to the ER only to learn that a subconjunctival hematoma is apparently not all that uncommon for people who have just had eye surgery.

I think this is one of those things that people are justified to be concerned about. It could just be an "ordinary" bleeding eye condition acquired from sneezing too hard or recovering from eye surgery, but if it it is in fact a hint at a much bigger problem, the person who has it can't feel it because it's painless. They can't see it because it's on their eyes.

It's worth a little irritation to train people to investigate if they see somebody with blood in their eyes.

hanley79

I had a subconjunctival hematoma last month -- or, as everyone who saw it said in concern, a burst blood vessel in my eye. Both names make it sound so serious. It really wasn't the worst medical condition I've ever had in my life -- certainly nothing in the suffering department when compared to my broken leg a few years back.

A burst blood vessel in the eye looks gnarly -- you've got red on the white area of your eye, and people notice it right away when they look at you. Honestly, the biggest amount of trouble I had with mine wasn't anything to do with the injury -- it was convincing other people who saw it that I was fine and didn't need to go to the hospital!

At first it was sweet of them to be concerned, but after a few days of that I was just plain irritated. If you see a person walking around with blood in their eye, but otherwise not in medical distress, do not call the ER. Calmly ask them if they know they have blood in their eye. If they're aware, then it's no big deal.

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    • Subconjunctival hematoma is a visible collection of blood in the eye.
      By: blueringmedia
      Subconjunctival hematoma is a visible collection of blood in the eye.
    • A subconjunctival hematoma can arise after a forceful sneeze.
      By: CandyBox Images
      A subconjunctival hematoma can arise after a forceful sneeze.
    • A broken blood vessel sometimes causes blood to collect in the eye.
      By: uwimages
      A broken blood vessel sometimes causes blood to collect in the eye.
    • If there are other symptoms that accompany a subconjunctival hematoma, it's important to visit an eye doctor.
      By: Monkey Business
      If there are other symptoms that accompany a subconjunctival hematoma, it's important to visit an eye doctor.
    • Routine eye examinations can help identify vision problems at an early stage.
      By: fred goldstein
      Routine eye examinations can help identify vision problems at an early stage.
    • High blood pressure can be a risk factor for a subconjunctival hematoma.
      By: Monkey Business
      High blood pressure can be a risk factor for a subconjunctival hematoma.
    • In many cases, a subconjunctival hematoma doesn't cause pain.
      By: FotolEdhar
      In many cases, a subconjunctival hematoma doesn't cause pain.
    • Eye surgery may cause a subconjunctival hematoma.
      By: Max Tactic
      Eye surgery may cause a subconjunctival hematoma.