Subconjunctival Hemorrhage

The conjunctiva is a clear membrane that covers the sclera (our firm, leathery eyeball).  If a small vein in the conjunctiva ruptures, a red spot of blood suddenly appears underneath.  It’s painless, completely harmless, doesn’t affect vision in any way at all, & eventually goes away.  But it certainly scares people, who may think their eye will bleed out..

“Hemorrhage” is what we call it, which really isn’t a good term at all.ย  It’s more like a simple bruise, which looks red because the conjunctiva is clear, as opposed to bruises elsewhere under skin, which makes them look purple.ย  Subconjunctival hemorrhage is usually caused by straining — anything from lifting a piano to coughing.ย  Pregnant women pushing during labor get them frequently.ย  Treatment is “don’t worry;” if they had a tiny bruise on their arm, they’d never have sought care.ย  I sometimes tell patients to invent a good story, how they fought off a marauding gang single-handedlyโ€ฆ

The only time I might worry is if a subconjunctival hemorrhage occurs after being hit in the eye.  It’s not more dangerous then, but might be a sign of deeper injury.  But usually not.  I consult an ophthalmologist if uncertain.

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