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Subconjunctival bleeding, also known as subconjunctival hemorrhage or subconjunctival haemorrhage, is bleeding from a small blood vessel over the whites of the eye. It results in a red spot in the white of the eye. [1] There is generally little to no pain and vision is not affected. [2] [3] Generally only one eye is affected. [2]
A subconjunctival hemorrhage can often occur without any obvious cause or harm to the eye. A strong enough sneeze or cough can cause a blood vessel in the eye to burst. Hyphema is a result of blunt or penetrating trauma to the orbit that increases intraocular pressure, causing tears in the vessels of the ciliary body and iris .
Secondary hemorrhage, or rebleeding of the hyphema, is thought to worsen outcomes in terms of visual function and lead to complications such as glaucoma, corneal staining, optic atrophy, or vision loss. [1] Rebleeding occurs in 4–35% of hyphema cases and is a risk factor for glaucoma. [4]
It is usually injection and prominence of the superficial blood vessels of the conjunctiva, which may be caused by disorders of these or adjacent structures. Conjunctivitis and subconjunctival hemorrhage are two of the less serious but more common causes.
The bulbar conjunctival microvasculature is known to dilate in response to several stimuli and external conditions, including allergens (e.g. pollen), [32] temperature, [33] time-of-day, [33] contact-lens wear, [13] and acute mild hypoxia. [24] Bulbar conjunctival vasodilation has also been shown to correlate changes in emotional state. [34]
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The resulting loose, excess conjunctiva may mechanically irritate the eye and disrupt the tear film and its outflow, leading to dry eye and excess tearing. [2] A correlation may also exist between inflammation in the eye and conjunctivochalasis, though it is unclear whether this correlation is causal.
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