Hyposphagma: blood in the eye due to subconjunctival hemorrhage

Hyposphagma describes bleeding in the eye caused by a “burst” vessel under the conjunctiva – so-called subconjunctival hemorrhage. Bleeding in the eye seems dangerous to most people at first. After all, the eye is considered to be particularly sensitive. However, a hyposphagma is harmless in most cases. In this article, you can find out more about hyposphagma, its causes and treatment.

What does a hyposphagma (subconjunctival hemorrhage) look like?

A hyposphagma can vary in severity. It is often only a minimal hemorrhage that is visible as a small red spot. Usually only one eye is affected. However, larger hemorrhages can also occur, in which half of the visible white of the eye (sclera) is affected. The hyposphagma is clearly defined.

A hyposphagma is usually only noticeable externally. Complaints such as eye pain, visual disturbances, itching or increased tearing should not occur with a hyposphagma.

Difference between bloodshot and reddened eyes

Occasionally a hyposphagma is mistaken for a mere reddening of the eye. In the case of simple redness, the white of the eye appears pink – the entire eye is affected. Redness is triggered by prolonged screen time, tiredness or dry air. In contrast, hyposphagma is an intense red coloration that rarely affects the entire visible white of the eye.

Causes of hyposphagma or subconjunctival hemorrhage

The causes of hyposphagma are varied and range from environmental influences to medication and illnesses:

• Trauma caused by an accident: Vessels can rupture as a result of the impact.
• Excess pressure in the vessel – Heavy lifting, pressing hard, sneezing, coughing: the increased pressure can lead to burst blood vessels.
• Rapid pressure fluctuations: For example, when diving or on an airplane.
• Frequent eye rubbing: An external effect that can injure blood vessels.
• Blood-thinning medication – e.g. aspirin, warfarin, anticoagulants: risk of hyposphagma is increased, especially if the dosage is too high.
• Arterial hypertension (high blood pressure): Leads to a heavy strain on the blood vessels.
• Blood clotting disorders: The risk of hyposphagma is increased.
• Conjunctivitis
• Dry eyes

Sometimes no specific cause is apparent – doctors may refer to this as an idiopathic hyposphagma. In older people in particular, it is often observed that a hyposphagma occurs spontaneously.

Hyposphagma – How long do the burst veins remain?

The hyposphagma usually develops within a very short time. During the healing phase, the hyposphagma may change color – comparable to the healing of hematomas (bruises) on the skin. The bleeding in the eye may then appear yellowish or greenish. The hyposphagma should disappear completely within two weeks.

Treatment of hyposphagma

Hypophagma does not usually require treatment if no other symptoms are present. The healing of the hypophagma cannot be accelerated – neither with cortisone nor with antibiotics or other medication. If the hypophagma causes your eyes to become dry, the doctor can prescribe eye drops or ointments to care for them. You can also take some measures yourself:

• Cooling: Cold packs can help to relieve swelling.
• Avoid blood-thinning medication: In consultation with your doctor, the dosage of blood-thinning medication can be adjusted if necessary to prevent further bleeding in the eye.
• Avoid touching the eye: To avoid further irritation of the blood vessels, rubbing and scratching the eye should be avoided as far as possible.

When should you see a doctor if you have a hyposphagma?

A doctor only needs to be consulted in rare cases due to a hyposphagma. This is the case, for example, with trauma caused by an accident – in this case you should even contact the emergency ophthalmology service. If the hyposphagma does not improve after a week, this should also be clarified. If you suffer from hyposphagma frequently, this could be a sign of high blood pressure or a coagulation disorder, which requires treatment. A visit to the doctor is also essential if other symptoms occur:

• Eye pain or headaches
• Feeling of pressure in the eye
• Deterioration of vision
• Loss of vision and visual impairment
• Nausea or vomiting

In some cases, bleeding may occur in the eye as a result of a traumatic brain injury. If this is the case for you, you should see a doctor immediately. An examination should be carried out to rule out a fracture of the base of the skull.

Diagnosis of hyposphagma

The eye specialist will recognize the presence of a hyposphagma simply by looking at the deep red color of the eye. If there are other symptoms, such as eye pain or a deterioration in vision, the intraocular pressure is also determined by measuring the intraocular pressure. Increased intraocular pressure associated with hyposphagma may indicate glaucoma.

Is a hyposphagma dangerous or mostly harmless?

A hyposphagma itself is not dangerous at first. However, causes for the hyposphagma, such as high blood pressure or blood clotting disorders, can be dangerous. These underlying diseases require treatment and should be treated by a doctor.

Conclusion: In most cases less bad than it looks

If you experience a hyposphagma, you should always observe it. However, a hyposphagma is often less dramatic than it sounds and looks. If there are no other symptoms, bleeding in the eye usually heals on its own in a very short time. If in doubt, a visit to the doctor will give you certainty.