By Joy Stephenson-Laws, JD, Founder

Popular culture seems fascinated with the idea of bloody or bleeding eyes. Television programs about vampires, politicians rebutting uncomfortable questions from reporters and gothic mystery novels routinely create vivid images of people with torrents of blood flowing from their eyes. And while this may be a common dramatic device to make a point or enhance a story, is it really based in reality? Can and do our eyes really bleed?    

The truth is that, except for a very rare medical condition called haemolacria which causes people to have blood in their tears, our eyes don’t bleed in a way that blood would flow from or through them to outside of our bodies. So, while we may all get an occasional “bloody nose,” you generally won’t hear about people spontaneously having “bloody eyes.”   

That is the good news. The not-so-good news, however, is that there may be only two conditions that can cause bleeding within our eyes and pose risks to our health.

Subconjunctival Hematoma

The first of these, a subconjunctival hematoma, is quite common. It happens when a blood vessel – or blood vessels – in the thin tissue that covers your sclera (the white part of your eye) burst. While the resulting red blotches and spots can be visually pretty dramatic, they are usually harmless. You usually won’t feel anything and probably won’t even notice it unless you look in the mirror or someone looks at you and exclaims, “What happened to your eye?” Your vision won’t be affected, and the hematoma will usually clear up on its own in a couple of weeks.

This type of bleeding may be caused by trauma to your eye, the use of contact lenses, blood thinners, coughing, diseases that decrease your blood platelets or high blood pressure. And because older blood vessels tend to be more fragile and rupture more easily, advancing age may increase your risk for a subconjunctival hematoma. Changes in pressure within your head, such as what happens when you scuba dive, lift weights, have a laughing fit, vomit or stand on your head, can also trigger a spontaneous hematoma in your eye. Rubbing your eyes can also cause this type of hematoma.

And don't confuse a subconjunctival hematoma with another common (and contagious) condition called pink eye, which is an inflammation of the conjunctiva. Also known as conjunctivitis, it also creates a “blood shot” look in the whites of your eyes. Since there are different causes for pink eye, if you get or have it you should talk to your doctor to treat it.  

While the vast majority of subconjunctival hematomas get better on their own without any intervention by you or your doctor, you should get in touch with your healthcare provider if:

• It does not go away on its own within two weeks
• You keep getting them
• Both of your eyes have these hematomas at the same time
• You experience bleeding gums, or you start to bruise easily along with the hematoma

You should call your doctor immediately or visit an urgent care facility if:

• You experience pain with the subconjunctival hematoma
• You have changes in vision (double vision, blurry vision, hard to see)
• You have a history of recent trauma or injury
• You have any kind of bleeding disorder

Retinal Bleeding

While subconjunctival hematoma is usually nothing to be concerned about, bleeding within the retina – the thin membrane at the back of the eye that literally gives us vision – is very serious since even the smallest injury to retinal blood vessels can result in temporary or permanent vision problems or even blindness. Some retinal bleeding will resolve on its own, but others will require medical intervention such as laser eye surgery to stop the bleeding and repair the broken blood vessels.

Many of the causes of subconjunctival hematomas are also responsible for retinal bleeding, including trauma, such as a blow to the head, and blood thinners. Others include vein thrombosis (blood clots that form in your veins) and retinal detachment (when the retina itself separates from the inside of your eyeball). Certain diseases which can affect your circulatory system, such as diabetes and hypertension, can cause retinal bleeding. In children, common causes are shaken baby syndrome and retinopathy of prematurity which occurs in premature infants whose retinas have not fully developed.

If you have any of the following symptoms of retinal bleeding, you need to consult with your doctor or an ophthalmologist as soon as possible to prevent any further damage to your eye and to protect your vision. (Keep in mind that retinal bleeding can occur suddenly and without any pain).

• Sudden appearance of spots, cobwebs or floaters in your vision
• Seeing shadows or a red hue to things
• Blurring of vision or loss of visual acuity
• Partial or complete loss of vision

Being Proactive with Eye Health

There are several things you can do to help protect yourself from subconjunctival hematomas and retinal bleeding as well as protect your eye health in general. These include:

• If you have diabetes, hypertension, a family history of eye disease, previous eye injuries or other risk factors, talk with your doctor to see what you can do to ensure that you are managing these factors as well as you can
• Be sure to get full ophthalmological exams every two years if you are under 60 and every year if you are 61 or over
• Eat a nutritionally balanced diet of fresh foods to help maintain eye health – for example, getting enough Vitamin D may help prevent macular degeneration  
• Protect your eyes from sun damage since even minor damage can impact your vision
• Avoid rubbing your eyes

By taking a few steps to take better care of your eyes and knowing the difference between retinal bleeding and subconjunctival hematoma, you can help protect your vision. Remember, your eyes are your windows to the world for as long as you live.

Enjoy your healthy life!

The pH professional health care team includes recognized experts from a variety of health care and related disciplines, including physicians, attorneys, nutritionists, nurses and certified fitness instructors. This team also includes the members of the pH Medical Advisory Board, which constantly monitors all pH programs, products and services. To learn more about the pH Medical Advisory Board, click here.