Consultant Eye Surgeon Dr S.S. Gill

Subconjunctival Heamorrhage

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Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh
Dr S.S. Gill

Eye Health

Ipoh Echo’s Eye Health series continues with Consultant Eye Surgeon Dr S.S. Gill talking to us about Subconjunctival Haemorrhage.

Subconjunctival Haemorrhage or subconjunctival bleeding is a condition where there is bleeding under the conjunctiva. The conjunctiva is the clear transparent layer that covers the white part of the eye (sclera). When the white of the eye has a bleed, this is called subconjunctival haemorrhage. Every other week, someone or the other walks into the consultation of an Ophthalmologist seeking treatment for this.

The appearance of such a bleed is often alarming to a person. Thankfully, it is generally a harmless condition when it occurs by itself and it is confirmed that the person has no other underlying serious conditions associated with it.

Consultant Eye Surgeon Dr S.S. GillWhat does it look like in the eye?

Subconjuntival haemorrhage or a subconjunctival bleed appears blood red and is located over the white of the eye (see adjacent picture).

It may appear in any area of the white part of the eye. It does not cause any pain but may cause some discomfort or heaviness if there is a large amount of blood collection.

Who gets subconjunctival bleeding?

Subconjunctival bleeding may occur in any age group – in adults, children or even infants. It is basically a bleed that arises from the tiny blood vessels of the conjunctiva. These tiny blood vessels are fragile and easily bleeds into the white of the eye.

What are the causes of subconjunctival bleeding?

The commonest cause is trauma of some form to the eye. This may range from too vigorous rubbing of the eyes, swimming goggles that are too tight, any direct trauma of any nature to the eye, head injuries, severe cough or sneezing, severe straining when lifting heavy objects or straining when passing stools especially when one is constipated. It may be also seen in those who do bungee jumping and in children who have been  physically abused.

Underlying systemic conditions that may cause this is uncontrolled hypertension, bleeding disorders, those who may be on anti-platelet (blood-thinning medication) therapy, and also sometimes it maybe seen immediately after eye surgery, particularly Lasik.

Should you be concerned?

Subconjunctival bleeding does not cause any problems with vision and is generally a harmless condition. However, it is important to be sure that it is not associated with some underlying systemic illness of the body.

How is it treated?

If it has been confirmed that the subconjunctival bleeding is not part of a systemic illness like uncontrolled hypertension, a blood disorder, etc., then it will not require any form of treatment because it is harmless. The reason it does not require any treatment is because the body’s natural mechanisms of healing will absorb the blood collection. It usually takes a few days to a few weeks for the blood collection to clear. The smaller the bleed, the faster it  gets absorbed. Those with a large collection of blood may take longer.

Subconjunctival bleeding while harmless in most instances, should be checked out especially if it occurs spontaneously and it has occurred with no direct trauma to the eye. If you are in doubt as to the underlying cause of the bleed, do consult your local practitioner or eye doctor.

For more information, call Gill Eye Specialist Centre at Hospital Fatimah

(05-545 5582) or email gilleyecentre@dr.com.