What happens in the eye
The conjunctiva is penetrated by a network of tiny vessels. When one of them ruptures, blood spreads into the space between the conjunctiva and sclera and is visible as a red spot. Because the blood is on the outside of the eyeball, it does not enter the eye and interfere with vision. The size of the spot varies from a point to the entire visible part of the protein. Over time, the blood is absorbed and the spot changes color to a yellowish color, like a bruise on the skin. It is important to distinguish this condition from hemorrhage inside the eye, which manifests itself as decreased vision and requires urgent treatment.
- Petechial hemorrhage
- Extensive - covering most of the protein
- Spontaneous - without obvious reason
- Traumatic
- Recurrent hemorrhages
Causes and risk factors
Most often, the vessel ruptures during a short-term sharp increase in pressure in the veins of the head: during an attack of coughing, sneezing, vomiting, straining due to constipation, lifting heavy objects, or intense training. Other causes include eye rubbing, careless putting on and removing contact lenses, injuries, surgeries, and eye injections. The fragility of blood vessels increases with age, with arterial hypertension, diabetes mellitus and atherosclerosis. Drugs that reduce blood clotting increase the likelihood of hemorrhage. Sometimes it occurs with viral conjunctivitis. Less commonly, blood diseases are the cause.
- Severe cough, sneezing, vomiting
- Straining and lifting weights
- Eye rubbing and contact lenses
- Injuries and eye surgeries
- Arterial hypertension
- Anticoagulants and antiplatelet agents
- Diabetes mellitus, blood diseases
Symptoms
Usually a person notices hemorrhage by looking in the mirror, or others tell him about it. The spot is bright red, with smooth edges, and does not extend onto the cornea. As a rule, there is no pain, vision does not change. There may be a slight foreign body or scratching sensation when blinking, especially if the spot raises the conjunctiva. Over the course of several days, the spot may increase slightly, then begin to fade at the edges and turn yellow. Pain, photophobia, discharge from the eye, and decreased vision are not typical for simple hemorrhage and require examination.
- Bright red spot on the white of the eye
- No pain
- Normal vision
- Mild discomfort when blinking
- Gradual yellowing of the stain
What examinations are needed
In the first episode without injury or complaints, a slit-lamp examination by an ophthalmologist is often sufficient to ensure that the eye is not damaged and to measure intraocular pressure. Everyone should check their blood pressure, and if it fluctuates, undergo 24-hour monitoring. People taking warfarin and other anticoagulants have their clotting rates monitored. If hemorrhages recur or are combined with other signs of bleeding, a general blood test with platelets and a coagulogram are prescribed. After injury, damage to the eyeball and orbital fractures are excluded, using CT if necessary.
- Slit lamp examination of the eye
- Blood pressure measurement
- Daily blood pressure monitoring
- Complete blood count with platelets
- Coagulogram, INR in those taking anticoagulants
- CT of the orbits after injury
What to do and how to treat it
Subconjunctival hemorrhage does not require special treatment; the blood resolves on its own. If you feel dry and gritty, your doctor may recommend moisturizing drops. Don't rub your eyes; stop wearing contact lenses for a while if they cause discomfort. Vasoconstrictor drops do not remove the stain. Blood thinners cannot be stopped on your own - this can be dangerous for the heart and blood vessels; the decision is made by the attending physician. It is important to find out and eliminate the cause: control blood pressure and blood sugar, treat cough and constipation.
- Observation - blood resolves on its own
- Moisturizing drops for discomfort
- Don't rub your eyes
- Taking a break from wearing contact lenses
- Blood pressure control
- Do not stop anticoagulants without a doctor
- Treatment of cough and constipation
