Blood in the white of the eye usually refers to subconjunctival haemorrhage, but trauma and surgery can also cause more extensive bleeding. The appearance is of a bright or dark red patch over the sclera.
Causes
Sudden pressure changes from coughing, vomiting, or straining, minor injury, or rubbing often break small vessels. Use of anticoagulants, hypertension, and systemic vascular disease increase susceptibility, and more serious trauma may produce larger or multiple areas of bleeding.
- Most cases are painless and discovered incidentally in the mirror
- Associated bruising or decreased vision suggests deeper involvement
- Eye surgery commonly leaves temporary subconjunctival blood
- Rarely, bleeding disorders present with recurrent ocular haemorrhages
What to Do
Simple haemorrhages resolve without treatment, but medical review is sensible if they recur, cover the whole eye, or follow significant injury. Underlying systemic factors may need attention.
- Lubricants may improve comfort and cosmetic recovery
- Avoid heavy lifting or straining until bleeding settles if advised
- Monitor blood pressure and discuss medications with a doctor if episodes are frequent
- Urgent assessment is required for any associated pain or visual change
