Sub-conjunctival haemorrhage

Subconjunctival haemorrhage (S-CH) is the result of rupture of conjunctival or episcleral blood vessels. Most cases are idiopathic, with a higher incidence of in those aged over 50. Traumatic causes, such as minor injury, ocular surgery or contact lens mishandling, are more often seen in younger adults. Recurrent episodes can indicate raised blood pressure or a bleeding abnormality. This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing and treating S-CH. It provides recommendations for non-pharmacological management and pharmacological treatment, and outlines when emergency referral to hospital A&E is necessary.

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What is sub-conjunctival haemorrhage?

Sub-conjunctival haemorrhage (S-CH) is a common condition which is not serious but very occasionally indicates a significant medical condition. It occurs when a small amount of bleeding takes place beneath the conjunctiva (the membrane overlying the white of the eye) and is similar to a bruise elsewhere. It appears bright red because the conjunctiva is transparent. This may happen spontaneously (that is, with no apparent cause) or as the result of minor injury, for example when a contact lens is mishandled. It can also indicate raised blood pressure or a bleeding abnormality. S-CH occurs more often in people taking blood thinning medications or aspirin, and in people with diabetes.

How is subconjunctival haemorrhage managed?

The condition is often alarming because of its dramatic appearance but there is usually only mild discomfort and the haemorrhage usually disappears in 1-2 weeks without treatment. It is usual to check the blood pressure of people with S-CH and to investigate the problem if it recurs.

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Last updated

Sub-conjunctival haemorrhage
Version 13
Date of search 29.03.23;
Date of revision 30.05.23;
Date of publication 03.08.23;
Date for review 28.03.25
© The College of Optometrists