Why do I get recurrent bleeding in my eye that causes it to look bloodshot? (photo)

Doctor's Answers 3

Disclaimer: This answer is not a substitute for a consultation and examination. It refers to a diagnosis called 'subconjunctival haemorrhage', which may or may not apply in your case.

A 'subconjunctival haemorrhage' occurs when there is bleeding under the thin outer layer (conjunctiva) of the eye.

There are many possible causes, ranging from excessive straining, coughing, sneezing, to vigorous eye rubbing and getting hit or punched in the eye.

Sometimes, in the absence of any other known cause, factors such as dry eye and looseness of the conjunctiva (conjunctivochalasis) may also contribute to the condition by exacerbating the rubbing effect of the eyelid as it blinks over the conjunctiva.

If a person is taking blood thinning medications such as aspirin or easily bruises, and is getting bad subconjunctival haemorrhages, it may be worth consulting with their doctor to check on the dosage of their medication or the coagulation profile of their blood.

Having said all that, subconjunctival haemorrhages are usually harmless and get better on their own. There is no specific treatment for this condition, other than to look for possible contributing factors as mentioned above, and to treat them if present.

Probably the best thing to do is to see a doctor to have the diagnosis confirmed, and then take it from there.

Photo of Dr E-Shawn Goh
Dr E-Shawn Goh

Ophthalmologist

There are many causes of recurrent subconjunctival hemorrhages, and most of them relate to raised intra-thoracic pressure, or local trauma.

Common causes include simple eye rubbing due to dry or itchy eyes, use of topical eye drops like corticosteroids have also been known to make delicate conjunctival vessels more prone to rupture.

Young patients may get recurrent subconjunctival hemorrhages from a valsalva maneuvre (e.g. physical exertion, lifting weights, bout of severe coughing / sneezing, or even straining at the toilet). Elderly patients may find that use of anti-platelet agents may predispose them to such hemorrhages.

Rarely are systemic medical conditions a cause for such bleeds. If in doubt, you should consult your ophthalmologist for a detailed and targeted examination!

While we cannot be entirely sure what your condition is, it may seem like you are having a recurrent subconjunctival haemorrhage. Do see an eye specialist to confirm the diagnosis as red eye could also be an indication for eye infection or inflammation.

Should it be a recurrent subconjunctival haemorrhage, the eye specialist will need to rule out possible causes such as clotting issues or high blood pressure via a simple blood test. Recurrent subconjunctival haemorrhages could also be due to other causes which will require further investigations by your eye specialist.

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