What is hyphema?

Sometimes small blood vessels in the whites of the eyes break and cause a red spot or speck. This is called a subconjunctival hemorrhage. The blood vessels may break because of sneezing, coughing, vomiting, straining, or bending over, but sometimes there is no clear cause. The blood may look alarming, especially if the spot is large. It is usually not a cause for concern and will clear up in 2 to 3 weeks. Subconjunctival hemorrhage is usually not a serious problem if your vision is normal, there is no eye pain, and the bleeding does not cover a large portion of the white of the eye and does not spread into the colored part of the eye (iris).

Bleeding that occurs between the colored part of the eye (iris) and the cornea is called a hyphema. This is more serious than bleeding that occurs in the white of the eye. You may have mild pain or no pain at all. After an eye injury, blood usually appears immediately. But if the injury is mild, blood may not appear until up to 5 days later. You may also have vision changes. A hyphema may be a more serious problem for a person who has sickle cell disease. If you have a hyphema, see an eye specialist (ophthalmologist).

Medicines that help prevent blood clots may increase the risk of bleeding in both the white or colored part of the eye. When there is bleeding into the eye, do not take aspirin, aspirin-related products, or nonsteroidal anti-inflammatory drugs (NSAIDs) for pain because they can increase bleeding. Use acetaminophen (such as Tylenol) instead.

• Follow instructions to keep your eye from bleeding more, which could cause permanent vision loss.
• Wear an eye shield if directed. Follow any instructions about the position of your head while you are sleeping or resting.
• Consider avoiding air travel until your eye has healed. Changes in air pressure may cause pain and affect your eye.
• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Take pain medicines exactly as directed.
• If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, take only acetaminophen, such as Tylenol.
  • Do not take aspirin or other anti-inflammatory medicines. These include ibuprofen (Advil, Motrin) and naproxen (Aleve). They can increase bleeding.
  • Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen. Too much acetaminophen (Tylenol) can be harmful.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• Wash your hands before touching your eye.
• Do not rub your injured eye. Rubbing can make it worse.
• Use the prescribed eyedrops as directed. Be sure the dropper or bottle tip is clean.
• To put in eyedrops:
  • Tilt your head back, and pull your lower eyelid down with one finger.
  • Drop or squirt the medicine inside the lower lid.
  • Close your eye for 30 to 60 seconds to let the drops move around.
  • Do not touch the dropper tip to your eyelashes or any other surface.
• Do not use a contact lens in your hurt eye until your doctor says you can. Also, do not wear eye makeup until your eye heals.
• Do not drive if your doctor says not to.
• For the first 24 to 48 hours, limit reading and other tasks that require a lot of eye movement.