Bleeding From the Eye

Types of bleeding in the eye

Subconjunctival hemorrhage: the common burst vessel

The conjunctiva contains tiny, fragile blood vessels. When one breaks, blood spreads under the clear membrane and cannot be wiped away, giving a vivid red patch. You may notice it only in the mirror or when someone tells you.

Common triggers:

• a hard cough, sneeze, vomiting or straining on the toilet
• heavy lifting
• rubbing the eye or inserting contact lenses
• minor injury
• blood thinners such as warfarin, apixaban or aspirin
• high blood pressure or diabetes
• often no cause at all

The blood turns yellow-green as it is absorbed and disappears in 1 to 3 weeks, like a bruise. Large bleeds may take longer. Artificial tears can soothe mild scratchiness. Avoid aspirin for pain unless a doctor has prescribed it. See subconjunctival hemorrhage.

Hyphema: blood behind the cornea

A hyphema is usually caused by blunt trauma from a ball, fist, elastic cord or airbag. Blood settles at the bottom of the front chamber and may form a visible red line. It can raise eye pressure, stain the cornea and lead to rebleeding in the first few days. People with sickle cell disease or trait are at higher risk of complications. Treatment includes rest with the head raised, a protective shield, eye drops and pressure checks, and occasionally surgery. Any eye trauma with blood should be seen in an ER or by an eye specialist.

Vitreous hemorrhage and retinal bleeding

Bleeding into the gel at the back of the eye is not visible from outside. You see sudden floaters, dark spots or a red haze. The commonest cause is diabetic retinopathy, where fragile new vessels bleed. Others are a retinal tear or retinal detachment, retinal vein occlusion and wet macular degeneration. Read more about vitreous hemorrhage.

Other causes

• High blood pressure: very high readings can cause retinal hemorrhages and occasionally surface bleeds.
• Bleeding disorders: low platelets, leukemia or clotting problems may cause recurrent or bilateral bleeds.
• Conjunctivitis: some viral infections cause small surface bleeds.
• Newborns: small surface bleeds after vaginal delivery are common and harmless.
• Bloody tears (hemolacria): from conjunctival injury, tear duct tumors or nosebleeds tracking backward.

How doctors evaluate it

An eye doctor checks your vision and eye pressure, examines the front of the eye with a slit lamp and dilates the pupil to look at the retina. An ultrasound scan shows the retina when blood blocks the view. Blood pressure, and sometimes blood counts and clotting tests, are checked if bleeds recur.

Frequently asked questions

Is a burst blood vessel in the eye serious?

Usually not. A painless red patch on the white of the eye with normal vision is a subconjunctival hemorrhage and clears on its own in 1 to 3 weeks. Get it checked if there is pain, vision change, injury, or if it keeps happening.

What causes sudden bleeding in the eye?

Sudden surface bleeding is most often caused by coughing, sneezing, straining, rubbing or lifting. Blood thinners and high blood pressure make it more likely. Bleeding inside the eye is usually from diabetes, a retinal tear or trauma.

How long does blood in the eye take to go away?

A surface bleed usually clears in 7 to 21 days, changing color like a bruise as it fades. A hyphema often clears in about a week with treatment. Vitreous hemorrhage can take weeks to months and sometimes needs surgery.

Should I stop my blood thinner if my eye bleeds?

No. Do not stop a prescribed blood thinner on your own, as this can cause a stroke or clot. A single surface bleed rarely needs any change. Tell your doctor, who may check your blood tests or blood pressure.