Burst blood vessel in the eye: Causes and treatment

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A burst blood vessel in the eye, or subconjunctival hemorrhage (SCH), is a common condition that causes a patch of blood to appear on the white part of the eye. In most cases, it is harmless and goes away on its own.

Often, doctors do not know what causes a burst blood vessel in the eye, but it can occur due to the use of contact lenses, an injury, or intense exercise or straining. Some people have an increased risk of SCH due to a medication or health condition.

This article discusses burst blood vessels in the eye and their causes and treatments. It also covers when someone should seek medical help.

SCH is the medical term for when a tiny blood vessel in the eye bursts, allowing a small amount of blood to leak onto the sclera, or the white part of the eye.

The sclera has many minute blood vessels that can break and bleed easily. They are protected by the conjunctiva, which is a thin, transparent layer of tissue that covers the eye. When a blood vessel breaks, blood pools under the conjunctiva, meaning it is visible but trapped under this layer of tissue.

Usually, a burst blood vessel in the eye is harmless. In most cases, the mark on the eye will go away on its own with time, as the blood naturally disperses.

The eye may be red for a while, but this should begin to fade over the next 1–2 weeks.

Occasionally, SCH can be a sign of an underlying condition. This is more likely if the bleeding is persistent or recurs often.

The main symptom of SCH is a red patch appearing on the white of the eye.

At first, the patch may be an opaque red with clear borders, before becoming faded and less distinct. The eye may develop a bruised or yellow appearance as the hemoglobin and other blood components break down.

Usually, SCH is painless and does not affect vision, although it may cause a swollen or scratchy feeling. It typically only affects the whites of the eyes, not the iris or pupil.

Doctors categorize the potential causes of SCH into two groups: traumatic and spontaneous.

Traumatic

In this context, the word “traumatic” refers to a physical trauma or injury that affects the eye, causing a small blood vessel to break. Foreign objects getting into the eye or harsh rubbing of the eyes are some common examples.

Another common cause of this type of injury is the use of contact lenses. As contact lenses have become more popular, the incidence of traumatic SCH has also increased.

This can occur by accident when applying or removing the lens or due to issues with the lens itself, such as surface deposits or defects that may cause friction.

If people use disposable contact lenses for longer than the manufacturer advises, this may also contribute to SCH. This is because the materials in these lenses start to break down at the edges over time, causing rougher edges.

In addition, people who wear contact lenses can sometimes develop eye conditions that disrupt the flow of tears, causing inflammation or dryness. These include:

  • conjunctivochalasis, which is when excess conjunctival tissue develops on the eye
  • pinguecula, which is a noncancerous growth on the conjunctiva
  • superficial punctate keratitis, which happens when corneal cells die, causing pain and light sensitivity

Ocular surgeries, including cataract and refractive surgery, can also increase an individual’s risk of SCH. According to research, around 1–2% of newborn babies may have SCH following a vaginal birth.

Conditions that lead to eye rubbing, such as dry eye syndrome, allergies, and blepharitis, can also be contributing factors. These conditions cause eye discomfort and then eye rubbing, which can be involuntary or during sleep and can cause the blood vessels to burst.

Spontaneous

According to research, in almost half of all cases, doctors do not identify a cause of SCH. Experts call these cases spontaneous, because they occur for no apparent reason. Another term for this is “idiopathic.”

Sometimes, a blood vessel bursts in the eye when blood pressure suddenly increases. This can happen when someone coughs, vomits, or takes part in strenuous exercise, such as lifting heavy weights.

Some health conditions can also be responsible for a burst blood vessel in the eye. Hypertension, or high blood pressure, can cause this to happen even if a person is taking medication to manage the condition. Other vascular disorders, such as diabetes and hyperlipidemia, can also increase the risk.

Some other conditions that doctors associate with SCH are:

Some medications, including nonsteroidal anti-inflammatory drugs and anticoagulants, such as warfarin or heparin, may also make burst blood vessels more likely.

The research mentioned above states that the recurrence rate for spontaneous SCH is about 10% in people with no identifiable risk factors.

SCH usually does not require treatment. If it is causing discomfort, a person can use ice packs on a closed eye to reduce this. They can also use artificial tears to improve dryness.

However, if someone has a burst blood vessel in the eye frequently, this may indicate an underlying condition that does require treatment. How a doctor approaches treatment will depend on the root cause, which they can diagnose.

Individuals who experience SCH due to head trauma may require a specialist consultation with an ophthalmologist.

After SCH, the body naturally reabsorbs the blood in the eye over 1–2 weeks, depending on the size of the hemorrhage.

If an individual uses an anticoagulation medication, it may take longer to resolve, at around 3 weeks.

Most SCH cases resolve on their own and are not a sign of serious illness.

However, if the condition develops after someone experiences a head or facial injury, they should seek medical attention. A doctor can monitor for signs of concussion or damage to the eyes.

If a person experiences any other symptoms alongside the burst blood vessel, they should also contact a healthcare professional. Examples of symptoms that may be a cause for concern include:

If SCH happens often, and a doctor has not checked an individual’s blood pressure for a while, they should ask a doctor to do this.

Doctors refer to a burst blood vessel in the eye as SCH. It is typically a harmless condition that resolves by itself in 1–2 weeks. Usually, the only symptom is a patch of blood beneath the conjunctiva, which is the transparent lining of the eye.

SCH often has no identifiable cause. It may be spontaneous or due to trauma, including contact lens wear.

Although a burst blood vessel in the eye is not serious in itself, it may indicate an underlying health condition that requires evaluation by a doctor.

If an individual experiences recurring SCH, the condition does not resolve, or they experience other symptoms, they should seek medical attention.



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