An eye bleed can appear in the form of blotches or complete redness of the eye. A person may also experience blood stained tears. Eye bleeds can be harmless, but sometimes, they may indicate an underlying issue.
Eye bleeds can cause red blotches within the eye or complete redness across the white of the eye. In some cases, such as hemolacria, blood may appear in the form of tears.
The type of eye bleed a person has will determine the symptoms they experience.
This article will discuss some types of eye bleeding that can occur and what can cause them. It will also look at when to seek medical help.
An ocular hemorrhage refers to bleeding inside the eye. Within this category are the following types of hemorrhage:
Subconjunctival hemorrhage
Subconjunctival hemorrhage (SCH) is a common type of eye bleed. It occurs when a blood vessel is broken.
The blood can appear in the whites of the eyes. The effect can look dramatic, but the symptoms are generally painless. Also, SCH is not harmful.
There are two categories of SCH: traumatic and spontaneous. Traumatic SCH can occur due to local mild trauma, such as rubbing the eye. Spontaneous SCH is due to a medical condition, such as hypertension or diabetes. These conditions can cause blood vessels to become fragile and rupture.
According to one 2020 article, SCH generally does not typically require treatment and should resolve in 1–2 weeks. However, if it occurs due to a medical condition, a person should seek treatment for the underlying cause.
Hyphemas
A hyphema is a less common but more serious condition. With a hyphema, blood collects at the front of the eye, between the cornea and the iris.
A hyphema typically occurs due to a traumatic injury to the eye.
Some symptoms of a hyphema include:
- pain
- bleeding in the front of the eye
- sensitivity to light
- vision that is blocked, cloudy, or blurry
- nausea or vomiting, if intraocular pressure rises acutely
Bleeding deeper in the eye
Eye bleeding that a person cannot see at the surface includes the following types:
- Vitreous hemorrhage: The clear part of the eye is called the vitreous. A vitreous hemorrhage can cause the blood to enter the area.
- Subretinal hemorrhage: This is when bleeding occurs underneath the retina.
- Submacular hemorrhage: This is when bleeding occurs in the space between the retinal pigment epithelium and the retina, called the macula.
With these, a person may experience:
- the appearance of floaters
- blurry vision
- a red tint to the vision
- scotoma, which is a form of visual field loss where blind spots are present
Hemolacria
Hemolacria, or bloody epiphora, refers to when the body produces blood stained tears. These may come from the tear glands, but they can also come from other parts of the eye.
Wear or cuts on the inner eyelid can cause direct bleeding from the affected area. If the cause of the bleed is farther back, the bloody tears may come from the inner margin of the eye.
There are a variety of reasons that a person may have a burst blood vessel in the eye. These include:
- sustaining trauma to the eye, such as rubbing the eye or the presence of a foreign body
- injury to the orbital bones, which are the bones that surround the eye
- conjunctivitis
- a tumor in the eye
- contact lens use
- laser eye treatment
- coughing
- sneezing
- vomiting
- strenuous exercise
- Valsalva maneuver, which is a breathing method
Medications
Some medications that can increase the chance of experiencing an eye bleed include:
- blood thinners, such as warfarin and heparin
- nonsteroidal anti-inflammatory drugs, such as aspirin
- P2Y12 inhibitors, such as clopidogrel
Medical conditions
Some medical conditions that can cause bleeding in the eye include:
- hypertension, or high blood pressure
- diabetes
- high cholesterol
- anemia
- hemochromatosis, which is a condition that causes the body to absorb too much iron
- thrombocytopenia, which is a condition that causes low levels of platelets
- hemophilia, which is a condition that stops the blood from clotting
- some tumors
- leukemia
- Stevens-Johnson syndrome, which is a condition that affects the skin and mucous membranes
- telangiectasias, which is a condition wherein broken small blood vessels sit near the surface of the skin
- Terson’s syndrome, which is a vitreous, retinal, or subretinal hemorrhage that occurs as a result of intracranial hemorrhage or pressure
- aneurysm
- posterior vitreous detachment, which is a condition that causes the vitreous to detach from the retina
Hyphemas
According to the American Academy of Ophthalmology, most hyphemas occur due to sports-related injuries.
Some less common causes include:
Whether or not a person needs treatment will depend on the cause of the eye bleed.
SCH does not typically need treatment. However, treatment is necessary if the cause is due to an underlying medical condition.
Treatment for hyphemas and other types of eye bleeding may include:
- laser surgery to bring eye pressure down
- eye surgery in severe cases, such as non-clearing hyphemas that surgeons need to evacuate in the operating room
- eye drops to control inflammation, pain, and pressure
The type of eye drop an ophthalmologist prescribes will depend on the cause of the bleeding. Some examples include antibiotic, antiviral, and steroid eye drops.
At home, a person may need to:
- wear a special shield over the affected eye
- rest
- raise the head to help the eye drain
Bleeding within the eye is fairly common, and, in many cases, an eye bleed does not require treatment.
However, it is best to seek medical help in case the bleed is a symptom of an underlying condition or causes other problems later on.
With some eye bleeds, such as a vitreous hemorrhage or hyphema, it is important to seek medical attention as soon as symptoms appear.
An ophthalmologist may assess a person’s blood pressure and take blood for laboratory testing to see if the eye bleed is due to an underlying problem.
For more specific diagnoses, a doctor may use eye drops to increase the size of the pupils, making them easier to examine. They may also use an ultrasound or CT scan to look for injuries in or behind the eyes.
The most common type of eye bleed, SCH, tends to go away after 1–2 weeks.
However, if a person experiences an eye bleed due to a hyphema or more severe cause, treatment and recovery may take longer.
SCH is a common cause of a bleeding eye. This type occurs due to a burst blood vessel and typically affects the whites of the eyes.
Another cause of an eye bleed is a hyphema. This type occurs due to a tear in the anterior structures of the eye, and the blood collects at the front of the eye.
Other causes of eye bleeding include vitreous, subretinal, and submacular hemorrhages.
SCH that is not associated with an underlying medical condition does not usually require treatment. However, hyphemas and other causes of eye bleeding do require medical attention.
In general, if a person experiences an eye bleed, they should contact an ophthalmologist.
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