Sub-conjunctival haemorrhage (bleed in the white of the eye)

This is a common and often quite alarming condition that results in the appearance of blood on the white of the eye. It is frequently painless but certain activities or blood conditions can predispose someone to having an episode. If you have what appears to be a sub-conjunctival haemorrhage, especially if it is recurrent, you should have your eye checked by your optometrist.

A sub-conjunctival haemorrhage occurs when one of the small blood capillaries under the conjunctiva - the thin layer of clear tissue on the surface of the eye - has a small leak. Even though it is only a small quantity of blood, it spreads under the conjunctiva and looks very alarming. Often patients are not aware of the bleed until they see themselves in the mirror or are told by someone that their eye looks red!

CAPTION: A sub-conjunctival haemorrhage at the top of someone's eye that might be difficult to see given it's position under the top lid

In most patients these sub-conjunctival haemorrhages occur by chance and have no underlying cause. Heavy lifting or vomiting can cause them to occur, however, and certain blood-thining medications or blood conditions such as anaemia can make you more likely to have one. Other more serious conditions can cause a similar appearance in the eye, so the presence of one should prompt a check by your optometrist, especially if there is pain or loss of vision.

A sub-conjunctival haemorrhage does not require treatment and will naturally heal itself, like a bruise, in 1-2 weeks. The blood may discolour or settle towards the bottom of the eye during this time.

CAPTION: A sub-conjunctival haemorrhage healing over the course of a week.