WHAT'S WRONG WITH YOUR EYE?!
Have you ever awakened, showered, fetched the morning paper, sat down for a cup of coffee, and have your spouse look you in the eye and scream "what's wrong with your eye?" Many people have. As you rise to search for the closest mirror, you're wondering if she's lost it; nothing hurts, you see OK, and your eyes looked fine last night. Then you see it...that bright red spot on your eye, right next to the colored part. "My eye is bleeding!"
This adventure is re-enacted in my office at least once a week. That red spot is a subconjunctival hemorrhage. They are actually quite common and at least 90% of the time they are harmless and will cause you NO discomfort or vision loss. They LOOK a bit gruesome, however, and a visit to your eye doctor may be reassuring. I have seen them where they were so extensive as to cover the entire visible white portion of the eye...and that can be quite frightening. Something has caused a small capillary break under the clear membrane (conjunctiva) covering the white of the eye.
First, don't panic, it's not as bad as it looks! Your eye doctor will ask you if you've been hit in the eye or head in the last 24 hours. Then he will ask you if you have high blood pressure (hypertension). Have you had any coughing or sneezing spells lately? Have you done any heavy lifting or exerted yourself on an exercise machine? Have you rubbed your eyes? Do you take a lot of aspirin or have you been prescribed any blood thinners? Do you have seizures or have you had a bout with constipation?
After you respond in the negative to all the aforementioned questions, your doctor will diagnose the cause as idiopathic. That means...no known cause, or undetermined etiology.
The treatment for a subconjunctival hemorrhage is time. The blood will reabsorb over a period of 1-2 weeks and no evidence will remain. It is probably wise to discontinue wearing your contact lenses if the hemorrhage is near the cornea, as the lens fit may be affected. If your red spot is not near the cornea, contact lens wear is permitted. A lubricant drop may relieve some mild irritation, but symptoms are rare.
You might look for a "border" on
your red spot. You should find some "white" around the red, especially
near the back of the spot. You could also find a red to purplish
"bump" near the center of your hemorrhage. These are typical
findings. Just remember, there should be NO PAIN and your vision should
be
Subconjunctival hemorrhages typically surface in the morning, although the causative factor may have occurred the night or day before; it's a slow leak. The capillaries can be very fine and a small break may actually leak but one red blood cell at a time! That explains your surprise in the morning.
Remember to differentiate a hemorrhage from a "bloodshot" eye. The eye can look very red in either case, but the hemorrhage is a "solid" red mass versus the bloodshot look of a "pinkeye". The latter is an infection that oozes pus and may require medication, the former may look worse but simply requires reassurance.
However, your eye doctor should make the diagnosis, especially if you have had recurrent episodes. Frequent subconjunctival hemorrhages are NOT normal and need further investigation. If you have more than three in a period of a year, with no known cause, you should consult your physician for some blood tests.