Subconjunctival Hemorrhage – Diagnosis and Treatment

Diagnosis

A doctor or ophthalmologist typically identifies a subconjunctival hemorrhage by examining the eye and noting a bright red or dark patch on the sclera—the white part of the eye.

These hemorrhages occur when a small blood vessel breaks under the conjunctiva, often without pain or vision changes.

Special tests are usually not needed, unless the hemorrhages are recurrent or accompanied by other symptoms. In those cases, doctors may:

• Check your blood pressure.

• Review your medical history, including conditions like hypertension, diabetes, or clotting disorders.

• Order a blood test to evaluate platelet function or clotting ability.

• Assess your vision with a visual acuity test to ensure there’s no change in sight.

These steps help rule out underlying conditions that could be contributing to the bleeding.

Treatment

Most cases of subconjunctival hemorrhage do not require treatment and will clear up on their own in one to two weeks, similar to how a bruise fades.

To manage symptoms and promote comfort:

• Use artificial tears (lubricating eye drops) if the eye feels irritated.
• Avoid rubbing the eye, which may worsen the condition or cause additional bleeding.
• Do not stop or start blood-thinning medications without first consulting your doctor.
• Avoid aspirin or other medications that affect clotting unless advised by a healthcare provider.

If you experience frequent hemorrhages, bleeding in other areas, or have had recent eye surgery, talk to your doctor. Further evaluation may be necessary to rule out bleeding disorders or other systemic issues.

Getting Ready for Your Visit

Steps You Can Take Beforehand

Being prepared can help your visit with the healthcare provider go smoothly.

Here are a few steps you can follow:

• Make a list of any symptoms, even minor ones like mild eye pain or changes in vision.
• Write down key personal and health information. Include recent changes in your life, major stresses, or any new medical conditions.
• Record all medications and supplements you take. Note the dose and frequency for each item.
• Note if you use contact lenses and how often you wear them.
• Bring questions to discuss with the doctor. Consider asking about:
  • Possible reasons for your red eye
  • If you need further tests or specialist referrals
  • Whether the problem could return
  • Steps for caring for your eye at home
  • Risks of other problems like conjunctivitis, episcleritis, or scleritis

Tip: Writing everything down can help you remember important details during your appointment.

Questions Your Doctor May Ask

Doctors often ask detailed questions to help diagnose the cause of your red or irritated eye.

They may ask when you first noticed symptoms or changes in your eye. They might ask if you have felt any pain, discomfort, or vision changes.

Your doctor could ask if you have a history of eye problems such as conjunctivitis, episcleritis, scleritis, or other eye issues. They may want to know if you use contact lenses or if you have recently changed brands.

Your doctor might ask if you have had any recent injuries, illnesses, or changes in your health. They may also ask if you are taking any new medications or supplements.