Sub-conjunctival haemorrhage

A sub-conjunctival haemorrhage is caused by a bleeding blood vessel under the conjunctiva. Patients will often present after being told they have a red eye and may not have noticed any symptoms. They usually have no cause but are more common after coughing or vomiting excessively. Can also be caused by mild trauma.



  • Patients may describe a mild popping sensation in the eye prior to observing the redness
  • May describe a mild FB sensation or an eye ache
  • Usually symptom free
  • Ask/review use of any NSAIDs or anticoagulants
  • Any history of coughing, straining, trauma or vomiting 



  • A flat, bright red haemorrhage in the conjunctiva 


Eye examination

  • Check blood pressure
  • Observe lids and conjunctiva with white light
  • Instil 1 drop of proxymetacaine 0.5% with fluorescein 0.25%
  • Observe for corneal staining preferably using a blue light 



  • Give patient sub-conjunctival haemorrhage information leaflet
  • If no history of trauma, no treatment is required. Reassure patient that the haemorrhage will resolve over the course of about a week or two  
  • If trauma is the cause, consider referral to an ophthalmologist to ensure no underlying scleral damage or other injury
  • If subconjunctival haemorrhages are recurrent further investigations may be required to exclude any clotting disorders; however in most cases no underlying serious cause will be found


Last updated: November 2017