Why Do I Have Blood in the White of My Eye?

Blood spots in the white of your eye (subconjunctival hemorrhage) are caused by tiny blood vessels breaking just beneath the clear surface of the eye (conjunctiva). You will see a speck of redness on the white of the eye or a larger area of visible blood.

Sometimes, people wake up with this blood spot in the eye. While it can look scary, it is rarely an emergency and will get better on its own without treatment.

This article will go over the causes and symptoms of a blood spot in the eye. You will also learn when to see a provider about a blood spot in your eye that’s not getting better.

Signs of a Blood Spot in the Eye

A subconjunctival hemorrhage is a blood-red discoloration on the white of the eye. Over time, the redness will turn greenish or yellowish, like a bruise. 

A subconjunctival hemorrhage is usually painless, although some people may experience a scratchy sensation in the eye. The symptoms will usually disappear within two weeks.

If it's a little leak, a subconjunctival hemorrhage may only cause a small area of redness or even a tiny red speck in the eye.

If there is more leakage, the entire white of the eye may look red. In some cases, the affected tissues bulge out.

Blood in the Eye Causes

A subconjunctival hemorrhage can have several causes, including injuries to the eye, medical conditions, or sudden, forceful changes to the blood pressure.

Some of the potential causes of blood in the eye include:

• Eye trauma (injury)
• Forceful coughing, sneezing, or vomiting
• Excessive eye rubbing
• Heavy lifting
• Straining from constipation
• Severe high blood pressure
• Extreme changes in atmospheric pressure
• Certain conjunctival eye infections
• Use of blood thinners like warfarin

Pressure changes can occur as newborns pass through the birth canal during childbirth, causing blood in the eye that typically clears up within two weeks.

Risk Factors for Blood in Eye

The cause of blood in the eye remains unknown in about 40% of the cases, but research based on more than 36,000 people diagnosed with subconjunctival hemorrhage (along with other studies) identified some risks. They include a health history of:

• Hypertension (high blood pressure)
• Diabetes mellitus
• Cardiovascular disease
• Blood disorders (including leukemia and lymphoma)
• Eye surgeries or eye conditions (including ocular tumors)

Hormones also may be at work, with some evidence that estrogen may have protective effects. In some cases, people who wear contact lenses may be more at risk, too.

Diagnosing Blood in the Eye

An eye health provider (optometrist or an ophthalmologist) can do an eye exam to find out what caused the blood in your eye. They will ask you about your medical history and the medications you take. They will also check your blood pressure.

They may do some tests to find out what is causing blood in your eye, including:

• Slit-lamp exam: Uses bright light directed into the eye to check for injury or disease
• Ocular tonometry: Measures the pressure inside the eyes
• Blood tests: Factor VIII and partial thromboplastin time (PTT) to check for bleeding disorders

Self-Care for Blood Spot in Eye

Most blood spots in the eye get better on their own within two weeks. A blood spot in your eye usually does not need medical treatment. 

However, you might want to apply a warm compress to your eye as an at-home treatment to help heal a blood spot in your eye.

If you have eye irritation or scratchiness, it can help to use some over-the-counter (OTC) artificial tears.

Blood in the Eye: When to Worry

Blood in your eye can be a sign of something more serious. See a healthcare provider if you have any of the following:

• Blood in your eye that has lasted longer than three weeks
• Blood in your eye with eye pain
• Vision loss, including blurring and light sensitivity
• Recurring eye bleeding

Even though the appearance of blood in your eye can be disturbing, it's usually no cause for alarm, especially if you don't have any pain or vision changes.

Preventing Blood in Eye

Trauma to the eye is one of the most common causes of blood in the eye. Even rubbing your eyes too hard can cause subconjunctival bleeding. So it's important to protect your eyes when playing sports and working with tools; in other scenarios, goggles and other gear should be worn.

Straining can also lead to blood in the eye because of the sudden increased pressure when coughing forcefully or lifting a heavy object. Using the proper lifting technique may help to limit the risk.

You also can talk to your healthcare provider about medications like aspirin. Its properties as a blood thinner may not make it the best choice for over-the-counter pain relief if you experience blood in the eye. People who take blood thinners for other reasons often will need to continue them.

Outlook for Blood in Eye

In most cases, the blood in your eye that happens with a subconjunctival hemorrhage is not harmful and doesn't affect your vision. It will often heal on its own. Many people won't experience pain with the bleeding, although sometimes there is irritation with no long-term effects later.

But if you experience repeated episodes of blood in your eye, tell your healthcare provider. An underlying medical cause may be at work, requiring diagnosis and treatment.

Summary

Bleeding in the white of the eye is caused by a broken blood vessel. Eye injury, severe high blood pressure, forceful sneezing or coughing, eye infections, certain medications, or bleeding disorders can cause blood spots in your eye.

It is not usually an emergency and just causes a little blood-red discoloration that usually gets better on its own within two weeks. If it doesn’t, see your provider. They can figure out what the cause is and help you get the best treatment. 

Even though the appearance of blood in your eye can be disturbing, it's usually no cause for alarm, especially if you don't have any pain or vision changes. However, see a healthcare provider if you have recurring episodes or blood in your eye doesn't go away.