A haemorrhage occurs when a blood vessel (which is usually fragile) bursts or ruptures.  It is not uncommon and is due to a variety of causes.

1. Sub-conjunctival Haemorrhage

This is the most common type of eye haemorrhage.  It is harmless because the haemorrhage is OUTSIDE the eye. The bleeding looks scary but does NOT cause pain or permanent damage.

Causes

• Spontaneous (usually found on waking)
• Mild trauma like rubbing too hard or during removal of contact lens
• Excessive straining (weight lifting), straining at toilet or coughing
• Hypertension or Diabetes which is not well controlled
• Blood thinning medication (like Aspirin, Cardiprin, Plavix or Warfarin)

Treatment

Try to avoid all strenuous activities to prevent the haemorrhage from spreading.  Although it can resolve on its own, you may be given eye medication to help it resolve faster. The blood usually takes between 12-14 days to subside

2. Hyphaema

This is NOT common and only occurs when the eye is hit hard enough causing the blood vessels in the iris in the eye to bleed resulting in a collection of blood called hyphaema. This may cause eye pressure to rise and result in glaucoma with symptoms of pain, blurred vision and light sensitivity.

Causes

• Trauma to the eye (punch, tennis or squash ball)
• Complications of advanced diabetic retinopathy

Treatment

You should avoid all strenuous activities and have strict bed rest to prevent further secondary bleeding (which can happen within the first 3-4 days of the injury).  The blood usually takes between 12-14 days to subside but the vision may not return to normal as there may be damage to the lens or pupil causing a problem with focusing. There is also a risk of glaucoma and this patient should have a yearly checkup for lifelong. 

See an eye doctor if you develop pain during the healing period

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