By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

BRIGHT RED SPOTS ON EYE ARE COMMON, BUT USUALLY HARMLESS

Question: Does sitting in front of the laptop computer too long cause a red spot on the white of the eye? Does crying cause it too? Please help me. I'm very worried. I was so shocked when I woke up and saw that small red spot on the white of my left eye.

Answer: What you describe sounds like a common, very startling, yet virtually always harmless condition called a subconjunctival hematoma. The bright red spot is caused by bleeding from small capillaries under the surface of the white part of the eyeball.

The name of this condition is derived from the fact that this part of the eyeball is covered with a transparent membrane called the conjunctiva. The prefix “sub” indicates that the bleeding occurs just below this membrane.

Most people discover they have a subconjunctival hematoma when a very concerned person says, “My goodness, what did you do to your eye?” You might also notice it yourself first thing in the morning when you look in the mirror while you are putting on makeup, shaving or brushing your teeth. That “red spot” is the only sign of this condition that you’ll notice. You will feel just fine -- no eye pain, no vision problems.

Subconjunctival hematomas are usually caused by minor trauma to the eye, such as rubbing the eye during sleep. They also can appear after forceful sneezing or coughing, vomiting or lifting. These activities increase the pressure in the eye and can cause a surface blood vessel to rupture. A subconjunctival hematoma can often be seen in newborns due to the pressure of childbirth.

A subconjunctival hematoma does not usually require medical attention, though many people go to the doctor for a diagnosis. If someone is on an anticoagulant medication, a so-called “blood thinner,” then they should at least call their physician if a subconjunctival hematoma appears.

Most experienced family physicians can easily make this diagnosis in the office by taking a good history and performing an exam of the eye. There is really no treatment needed as this will get better on its own. If it is associated with sneezing or allergies, you should get those treated to prevent future occurrences.

Sitting in front of your computer for too long is probably not the direct cause of your subconjunctival hematoma. However, it could be an indirect cause. This would happen if you used the computer for a long enough time that your eyes became fatigued and then you started rubbing your eyes a lot. In this case, it would actually be the trauma to the eyes from rubbing them that caused the subconjunctival hematoma, not staring at the computer screen, per se.

Your question about crying probably has a similar answer. It’s not the act of crying that would cause a subconjunctival hematoma, but the eye rubbing that often accompanies crying.

If your red spot doesn’t go away in a week or so, it might be a good idea to see your family physician to make sure something else isn’t going on. Also, seek medical attention if you have frequent subconjunctival hematomas, as this could, in rare circumstances, be a sign of an underlying disease such as high blood pressure, uncontrolled diabetes, or hyperthyroidism.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.