Sub-conjunctival haemorrhage

This leaflet is designed to provide you with information about sub-conjunctival haemorrhage.

What is a sub-conjunctival haemorrhage?

The white part of the eye (sclera) and the inside of the eyelids are covered by a transparent membrane called the conjunctiva. The conjunctiva has blood vessels that lie underneath its surface. When these tiny blood vessels leak or break (similar to a bruise), blood gathers between the conjunctiva and sclera forming a small sub-conjunctival haemorrhage.

What can cause sub-conjunctival haemorrhage?

A sub-conjunctival haemorrhage is a common eye condition. The occurrence may increase with age. The most common causes are:

• Occur for no apparent reason (idiopathic).
• Trauma to the eye, such as surgery, rubbing the eye, coughing, sneezing.
• Hypertension (high blood pressure) or diabetes, which may make someone more susceptible to getting a sub-conjunctival haemorrhage.

What are the signs and symptoms?

You will notice a red spot of blood on the white part of the eye. It is not usually painful and happens suddenly. This will not affect your vision.

How is it diagnosed?

The ophthalmologist (eye doctor) or nurse practitioner would perform an eye examination.

No investigations are normally required; however, further blood pressure checks and routine diabetic test may be requested to be undertaken by your GP. Generally, sub-conjunctival haemorrhages do not need to be seen in the hospital eye department.

What treatments are required?

Treatment is not necessary for a sub-conjunctival haemorrhage as it will clear up on its own. The haemorrhage usually resolves in one to two weeks. You can carry on with your normal activities whilst the haemorrhage is healing.

What to do if symptoms get worse?

It is uncommon for symptoms to worsen, but if they do, or if the haemorrhage does not clear up within two weeks, please call our Emergency Eye Clinic (see below) or contact your local minor eye services.

'Worsening symptoms' include:

• the blood spot getting very large
• the eye becoming painful

Contacts

Emergency Eye Clinic

• Monday to Friday 08:30 to 16:00: 01223 217778 – leave a message with your name, date of birth, hospital number, and a brief description of your concern and one of the nurses will call you back within normal working hours.
• Out-of-hours: Contact Centre 01223 245151 and ask for the on-call ophthalmologist.

References/ Sources of evidence

Borooah, S., Sim, P.Y., Wright, M. and Dhillon, B., 2018. Ophthalmology pocket tutor. 2ed. JP medical. London.

Gerstenblith,A.T,and Rabinowitz M.P., 2012.The Wills Eye Manual: office and emergency room diagnosis and treatment of Eye disease.6ed.Philadelphia: Lippincott Williams & Wilkins

Jackson, T., 2008. Moorfields Manual of Ophthalmology. Mosby Elsevier. London