Bleeding in the eye: causes and treatment, what to do if there is bleeding

An eye hemorrhage is a spill of blood due to rupture of blood vessels.

The eyeball is penetrated by a blood network that nourishes its structures.

Under the influence of internal and external factors, blood vessels burst.

Blood spreads through the tissues. A hematoma forms and the eye appears red. The condition is accompanied by pain or goes away without discomfort. Bruise, systemic disease, increased blood pressure cause hemorrhage. Treat or wait - you can’t figure it out without a doctor.

We recommend reading: Vitreous hemorrhage

Why does bleeding occur in the eye?

The eye becomes swollen with blood due to the following factors:

• trauma - impact, burn, ingress of small fragments, shavings, scale;
• a sharp increase in pressure - an attack of hypertension;
• high intraocular and intracranial pressure;
• efforts - during labor pains, constipation, coughing, sneezing, vomiting, baby crying;
• blood properties - congenital low coagulability, drug-induced hemophilia;
• infectious diseases - conjunctivitis, leptospirosis;
• weak capillary walls - with hypovitaminosis of vitamins K, A and C, atherosclerosis, vasculitis, lupus erythematosus, diabetes;
• eye tumors - put pressure on surrounding tissues;
• surgery on the cornea;
• formation of blood clots in the retinal circulatory system;
• genetic predisposition to microaneurysms;
• retinal detachment.

People who abuse alcohol and nicotine suffer from eye hemorrhages. Vessels rupture due to pressure changes caused by alcoholic drinks and drugs.

Tension arises from spending a long time at the computer. After 10-12 hours of static looking at the monitor, the capillaries burst and the sclera becomes filled with blood.

General information about the retina and the current state of retinology

The retina is a layer of special light-sensitive receptor cells in the fundus of the eye that perceives the image focused by the eye. Next, it is transmitted to a special nerve, which, with its terminal disc, enters the most developed macular region of the retina () and serves as a conductor of the visual signal from the neuroepithelium to the visual zones of the cerebral cortex, where, through the processing and fusion of two separate signals, a single binocular image is built. Normal vision implies complete safety, consistency and correct “tuning” of all elements of the optical conduction tract.

At the same time, the human visual system is evolutionarily protected not as reliably and rigidly as some other systems of the body, and has significantly fewer resources for regeneration and damage compensation. Therefore, when the functional failure of ocular structures and tissues is caused by injury or disease, a person most often has to replace them - either with donor material (for example, corneal transplantation) or with synthetic material (for example, the well-known implantation of an artificial lens). As for the retina, firstly, it plays a completely exceptional role in the visual system, and secondly, it is too complex for the current stage of technological development, i.e. cannot yet be replaced by, say, an electronic transceiver device at the neural level.

Donor retinal transplantation today is also inaccessible, has not been sufficiently studied statistically and, in fact, remains only an experimental procedure, very expensive and complex. The first relatively successful attempts at such operations were made quite recently - in 2008 in Europe and then in 2014 in Japan, where the world's first retinal transplant grown from stem cells was performed. Regarding donor retinal transplants, the relativity of success is emphasized - vision is only partially restored, the stability of the effect is unknown due to the extremely short period and volume of observations. Reports on the functioning of the brainstem retina are generally distinguished by restraint and stinginess (“the patient’s field of vision has become brighter”).

Conservative, drug treatment of the retina by itself is ineffective and is prescribed mainly as additional or maintenance therapy. In fact, the only and most proven method of treating an affected, damaged, degenerating and/or detached retina is ophthalmic surgery (and timeliness is the decisive factor), especially in combination with excimer laser coagulation methods - in this case, the probability of success is immeasurably higher and is, according to various sources, from 70% to 90%.

From this brief review, a logical conclusion follows that folk wisdom came to a long time ago: the retina of the eye should be protected “like the apple of the eye,” and in case of the slightest problem, seek qualified help immediately. Otherwise, the risk of a pronounced decrease or complete loss of vision is very high.

Classification

Types of hemorrhages are divided according to location:

Subconjunctival, hyposphagma

Occurs in the transparent elastic layer, the conjunctiva. Between the outer shell and the sclera there is a space that is filled with blood from ruptured vessels. The effusion occurs due to injuries, operations, congenital or acquired fragility of blood vessels. More often, hyposphagma appears from overexertion, a surge in pressure and goes away on its own within 2-3 days.

Hemophthalmos

Spillage of blood in the vitreous body. A healthy structure resembles a transparent gel that allows light to pass from the lens to the retina. When the gel is filled with blood, it prevents light from reaching the retina. The person sees worse or loses visual ability.

Myopic people are more prone to ruptured blood vessels in the vitreous.

Types of hemophthalmos:

• total - loss of transparency by more than ¾ as a result of injury;
• subtotal - the vitreous body is filled with blood by at least a third, maximum by ¾, occurs in diabetes;
• partial - hemorrhage covers less than a third of the space.

Unilateral hemophthalmos is more common. The condition is dangerous due to loss of vision. The vitreous body is filled with blood contents - corpuscles, decay products, toxins. Under their influence, adhesions are formed in the structure. The longer the vitreous body is clogged, the less likely it is to naturally cleanse and restore the structure. The result is loss of vision due to fibrous hardening of the eyeball.

Hyphema

Hemorrhage in the anterior chamber of the eye. The transparent dome of the cornea covers the iris and lens. The dome space is filled with intraocular fluid. When a vessel ruptures, moisture mixes with blood. The anterior chamber is completely or partially filled. The degree of rupture depends on the depth of penetrating, non-penetrating and surgical damage. The hyphema settles at the bottom of the chamber. Vision partially deteriorates or the person goes completely blind.

Hyphema fills the chamber into 4 levels:

• takes up less than a third of the volume;
• half;
• more than half;
• the hyphema completely fills the volume of the chamber.

The iris becomes red with hyphema. At stage 4, it is not visible as the cornea turns into a black blood spot in the eye.

Retinal

Hemorrhages from ruptures of retinal vessels. Also dangerous for vision loss.

Kinds:

• Preretinal - a hematoma occurs between the retina and the vitreous body, larger in size than the head of the optic nerve;
• Intraretinal - appear due to damage to the retinal circulatory system of the retina. The appearance of hematomas indicates their location. The stripes are in the top layer, and the circles are in the middle;
• Subretinal - located behind the retinal vessels.

Hematomas are distinguished by the nature of their spread: extensive and small, unilateral and bilateral. Multiple vascular ruptures accompany systemic diseases. Unilateral rupture of the vessel is a consequence of mechanical damage.

Bottom line

Bleeding in the eye can indicate quite serious illnesses, so it should not be ignored. It is recommended to immediately contact an ophthalmologist who will give advice and provide professional medical assistance. This will minimize the risk of consequences that may arise due to untimely treatment or attempts to recover using traditional methods. Therapy is selected depending on the nature and severity of the hemorrhage. The doctor selects medications individually, depending on the clinical case.

Symptoms

The first manifestation is scarlet spots on the whites. Hemorrhage into the sclera of the eye is painless. But retinal hematomas do not reach the sclera, remaining hidden. And also not noticeable.

External and indirect signs of hemorrhage:

• Hyposphagma: blood on the white of the eye, foreign body sensation, itching. The bruise turns pale and disappears without additional treatment. Often the condition resolves without discomfort.
• Hyphema: spot of uniform color, change in color intensity when changing body position, blurred image, sensitivity to light. A small amount of blood at the bottom of the eye chamber may not be noticed. The extensive outpouring changes the color of the iris to red.
• Hemophthalmos: brown spot, partial or complete loss of vision, flashes cut through the image, dark spots of various sizes. A person sees dots and threads. When vision is lost, the sensation of light remains. Partial hemophthalmos is accompanied by improved vision in the evening. In a horizontal position of the body, for example, at night during sleep, blood particles are distributed throughout the vitreous body. Therefore, in the morning a person sees worse. During the day, when the body is positioned upright, blood moves to the lower part of the eye, allowing more light to penetrate the vitreous gel.
• Retinal hemorrhage: the image is crossed with a color grid, flickering dots, blurred outlines of objects, blurred vision, blindness.

Excess blood causes exophthalmos, a forward displacement of the eyeballs. It's hard to move your eyes. Blood comes out from under the lower eyelid. If a small hemorrhage appears once, there is no reason to worry. But systematic ruptures of blood vessels in both eyes require careful diagnosis.

With skull fractures, the effusion can reach the skin around the eye socket.

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Treatment

To remove hemorrhage, conservative therapy with eye drops is prescribed:

• potassium iodide - accelerates the resorption of the subconjunctival spot, hyphema, occupying a third of the anterior chamber;
• drugs for constricting blood vessels;
• agents that reduce intraocular pressure.

If a superficial vessel has burst, it is enough to support the eye with artificial tears at home. It is impossible to drip vasoconstrictors on your own in case of persistent hematomas. The effect of the medications will make it difficult to determine the cause of the disorder.

Treatment of hematomas includes the elimination of external factors:

• quitting smoking, alcohol;
• reduction of physical activity;
• withdrawal of anticoagulants;
• peace.

It is necessary to eliminate emotional overload and limit computer work. In severe cases of skull fractures, the patient must remain in bed.

Maintenance conservative therapy is indicated for established systemic diseases - diabetes, atherosclerosis, hypertension. The main treatment is aimed at normalizing the patient’s general condition:

• taking medications that regulate blood pressure;
• elimination of hypovitaminosis with the help of vitamin complexes;
• strengthening of blood vessels with angioprotectors.

Retinal hemorrhages are treated in the inpatient department with medications:

• corticosteroids;
• angioprotectors;
• antioxidants;
• non-steroidal drugs that relieve inflammation;
• drugs that facilitate the removal of eye fluid.

For extensive, complicated hematomas, surgical intervention is required. Indications for surgery:

• retinal detachment due to hemophthalmia;
• no changes after 3 weeks of treatment;
• the blood in the eye is caked and coagulated;
• the hematoma has spread to other parts of the eye;
• persistently high eye pressure;
• decreased vision;
• penetrating trauma.

In rare cases, if there is severe bleeding under the conjunctiva, the doctor makes a puncture.

Types of operations:

• laser coagulation - done for retinal hemorrhage;
• vitrectomy - removal of the vitreous body.

The laser emits heat, under the influence of which the torn vessels are connected. The high temperature of the photocoagulator seals the retina, preventing detachment. The operation does not injure surrounding tissues.

Vitrectomy is a procedure to remove the vitreous substance. The operation is performed through micro-incisions.

When to go to the doctor?

Ideally, if a vascular structure in the eye has burst, you should immediately seek help from an ophthalmologist. But when this is not possible and the suspected causative factor is known, you can simply observe the hemorrhage. If it decreases, there is most likely no cause for concern. When the hemorrhage does not go away after a week, you need to seek medical help.

Dynamics of subconjunctival hemorrhage with a small size

There are situations when a burst vessel can pose a health hazard:

• if the hemorrhage appears after severe trauma to the eyeball or head;
• frequent episodes of hemorrhages without objective reasons, in this case a disease may develop in the body that contributes to the fragility of blood vessels;
• if, in addition to hemorrhages, there are other signs of increased bleeding, for example, from the nose, gums.

You should definitely seek help if, in addition to hemorrhage, you are concerned about other ophthalmological symptoms: decreased visual acuity, loss of visual fields, the appearance of dots or blurred vision, pain, pain, discharge from the eyes.

How long does it take for bleeding in the eye to go away?

The rate of resorption of an ocular hematoma depends on the condition of the vessels, location, and degree of damage.

The recovery period after effusion in the conjunctiva is from 3 days to a week. Hemophthalmos, hyphema, and retinal hemorrhage also occur in standby mode under the supervision of a physician. Treatment of a bloody eye can take from 3 weeks to 2-3 months, depending on the origin of the hematoma. If the cause is injury, the tissue will recover naturally. In diabetic retinopathy, recurrent ruptures cannot be ruled out.

Forecast

In most patients, retinal hemorrhages resolve well. Sometimes, in their place, delicate connective tissue moorings develop or mottling of the macular zone remains, as a result of which visual acuity sharply decreases. Therefore, to preserve vision, it is important to promptly contact a specialized eye clinic with doctors who know and can treat such diagnoses. We will be happy to help you - call to ask your questions and make an appointment.

You can find out the cost of basic diagnostic procedures and surgical procedures performed in our clinic in the PRICES section.

Prevention

Bleeding into the eye occurs spontaneously, so there are no special measures to prevent it. For chronic diseases that cause weakness of the vascular network of the eyes, it is recommended:

• undergo an ophthalmological examination once every six months;
• moderate physical activity;
• control blood pressure, glucose levels;
• in case of bilateral redness, decreased vision, pain, consult a doctor;
• do not touch the bleeding site with your hands;
• correct vision with constant wear contact lenses;
• observe the computer work schedule;
• read, watch TV in good lighting;
• do not bend low and sharply;
• when working in the garden, do not stand bent over, but sit on a stool;
• protect your eyes from the sun and wind;
• take vitamins C, P;
• do not stay in a bathhouse or sauna for a long time;
• do not abuse alcohol;
• get a good night's sleep.

Artificial tears will help relieve dryness and discomfort.

Tips on what not to do if your eye is bloodshot:

• hot, cold compresses;
• rinse with tea;
• instillation of antibiotics, antibactericidal drops;
• drip vasoconstrictors;
• apply drops that whiten the sclera.

Heat and cold contribute to the spread of infection. Tea may cause conjunctivitis. Therapeutic drops should be selected by a doctor after making a diagnosis.

Causes

There are different reasons:

• Injuries to the eye, orbit, or skull. Blunt, strong blows to the head are especially dangerous. After receiving such an injury (even if there are no symptoms), it is necessary to undergo an examination by an ophthalmologist.
• Infectious viral diseases. Hemorrhage occurs due to inflamed mucosa.
• Development of hypertensive crisis. A rapid increase in blood pressure can lead to disruption of the integrity of blood vessels. This happens especially often in older people or in patients suffering from diabetes or autoimmune diseases.
• Vomiting and severe coughing (physical strain) can lead to minor hemorrhage. Despite the fact that the redness of the eye can be severe, the condition is not classified as dangerous.
• Taking medications that reduce blood viscosity. These include the popular painkiller and antipyretic, aspirin, which is often taken in large doses and without a doctor’s prescription.
• Vitamin K deficiency. This is a rare pathology. Vitamin K is produced by the intestinal microbiota, and most often deficiency develops after massive antibiotic therapy or in chronic diseases of the immune system or gastrointestinal tract.
• Hereditary bleeding disorder - hemophilia.

The risk increases significantly in the presence of any chronic pathologies of the heart, blood vessels and internal organs, as well as in the first few weeks after eye surgery.

Hemorrhages can occur in children of any age: from newborns to adolescents. The reasons are basically the same as in adults.

Eye damage from impact

Actually, what kind of damage can a blow to the eye cause? First of all, it is worth mentioning the contusion of the orbit, which does not violate the integrity of the tissue cover. In this case, the organ of vision will become not only red. In addition, contusion causes decreased visual acuity and limited mobility of the eyeball.

In cases where the impact leads to a violation of the integrity of the tissue cover, damage to other organs located in the immediate vicinity is possible:

• Muscles;
• Tear duct;
• Lacrimal gland.