The sudden appearance of a red spot on the white of your eye can be very unnerving as it appears that the eye is bleeding. When it materializes without a history of trauma or other health problems, there is usually not a serious problem. Still, is hard to imagine anything more disturbing to look at than a blood red eye.
The Front of your eye has a mucous membrane layer called the conjunctiva. This thin transparent tissue forms a loose covering over the white part of the eye, the sclera, and extends under the eyelids. It has a thin layer of surface cells called the epithelium and a layer of connective tissue below this where small blood vessels,nerves, goblet cells (that secrete mucous) are located. The conjunctiva is extremely sensitive to inflammation because of a large number of mast cells(the cells that release histamine when you are exposed to an allergen).
Since the conjunctiva is loosely bound to the underlying sclera there is a potential space for blood to accumulate in. The small blood vessels in the tissue are capillaries, and they have fenestration to allow fluid exchange. Because they are so small and are subject to more movement and subsequent shearing forces in the loose conjunctiva tissue, it is not uncommon for a vessel to break and bleed. This blood spreads out in the space underneath the conjunctiva and appears to be a much larger volume than it is due to the thinness of the film of blood.
A number of events can trigger a hemorrhage under the conjunctiva. Coughing, vomiting, sneezing, straining for a bowel movement all increase blood pressure temporarily and can cause a sub-conjunctiva hemorrhage. Some activities such as rides at amusement parks with rapid acceleration and deceleration increase the blood pressure in the thoracic cavity and the head, which has been shown to cause hemorrhages. Merry go rounds can have the same effect. Rubbing your eyes may also mechanically burst a capillary as can any form of trauma to the eye.
Conjunctiva hemorrhages are not painful and do not lead to sight loss. They are equivalent to a bruise and undergo color changes over several weeks as they resolve and gradually reabsorb.
Any bleeding seen on the eye needs a thorough eye examination by your eye doctor to rule out other serious problems. Trauma could cause an unknown eye perforation that results in blindness if not treated. Any recurrent episodes warrant evaluation for underlying problems and diseases that make you more susceptible to having fragile blood vessels.
High blood pressure, arteriosclerosis (accumulation of cholesterol on your blood vessels), some types of blood cancers,diabetes,HIV and other diseases increase the frequency of conjunctiva hemorrhages. Drugs can cause hemorrhages including blood thinners (Coumadin), aspirin, ibuprofen (Advil), and even Birth Control Pills in rare instances. Some systemic diseases; flu,measles, malaria, and rare viruses similar to Ebola are factors.
Conjunctival hemorrhage has been reported as a result of embolism from breoken bones and different types of surgery.
Some viral eye infections can cause hemorrhagic conjunctivitis. Acute hemorrhagic conjunctivitis is a specific viral disease seen more commonly in lessor developed countries and is characterized by large outbreaks of eye infections with conjuctival hemorrhages.
One other rare cause of conjunctiva hemorrhage is referred to as Vicarious Menstruation. Little or no uterine bleeding occurs but bleeding occurs monthly and can occur almost anywhere on the body, though it is more common in the respiratory track,noes, gums, and conjunctiva. There have been patients who have eye hemorrhages every month at the time of their menstrual cycle.
Relax, Call the office and let us take a look at your eye. The odds are overwhelming it is an innocuous event that will causes you no problems other than a slightly scary looking eye. Although occasionally a torn contact lenses edge can cause the problem, it is often not necessary to stop wearing contact lenses for the eye to heal. If you have teenagers tell them “Twilight” wasn’t really fictions after all!
The conjunctiva tissue is small but vital to keeping mucous on your eye surface for a healthy tear film, allows the eyelid to smoothly resurface the cornea on and keep your vision clear, while preventing dry eyes. It is very active in the eyes own immuine system. Make sure you keep it healthy with routine eye check ups. Most vision insurance plans like Vision Service Plan (VSP) provide well coverage visits.