Blood in the eye - causes, symptoms and therapy

Blood in the eye; Bleeding from the eyes (conjunctival hemorrhage; hyposphagma)
Blood in the eye, which occurs as a delimited undershoot of the conjunctiva, is called hyposphagma. This leads to extensive, mostly dark red bleeding under the conjunctiva, which can sometimes appear very dramatic. In most cases, however, the eye bleeding is harmless and has no consequences. If the hyposphagma occurs repeatedly, specialist medical advice should be consulted.


Our eyeballs are usually white, with red veins running through them, but they can easily be recognized as such. If the white turns red, it is usually due to blood. Bleeding in the eye can have various causes - from open wounds to bruises to broken veins. Injuries are of course initially the cause, but the bleeding of the eyes can also occur suddenly after a strong cough (e.g. with whooping cough) or pressing during labor. Rarely, the hyposphagma can also be a symptom of high blood pressure, arteriosclerosis and diabetes mellitus, or it can be a sign of a blood clotting disorder.

The eye is not the same as the eye, and blood is not the same as blood. The eye is a very complex organ and numerous blood vessels run through it. Bleeding occurs in the following parts of the oculus: dermis, conjunctiva, cornea, iris or vitreous. In addition, the blood in the eye can also come from an injury outside the eye: A cut on the skin of the eyelid, for example, is not a wound in the eye. Nevertheless, blood can collect on the outside of the eye and looks similar to blood that turns white in the eye red.

As a rule, the eye bleeding is spontaneous, painless and without further complaints. Therapeutic measures are usually not necessary, the bleeding disappears after two weeks at the latest. In the event of repeated occurrence, however, those affected should be examined for the possible underlying diseases, which are then the focus of the therapy. A distinctive diagnosis is the extensive bleeding of the eyes from the reddening of the eyes, which is based on other causes.

External injuries

These are the most common causes of blood in the eye. Our visual organ is sensitive to external pressure. A blow to the eye or foreign objects such as the edges of contact lenses cause bleeding. These are often bruises, but sometimes veins burst or cuts damage our visual system.

We generally differentiate injuries with blunt objects, such as tennis balls or soccer balls, the steering wheel of a car or the curb, which exert pressure and thus lead to bruises, bruises and broken veins from sharp objects which cause wounds such as cuts with knives, broken glass or Thorns.

A black eye that catches the eye?

We literally say "someone got away with one black eye again". A black eye is a bruise, especially in the region around the eye - in the eyelid area. The tissue around the eye swells and the bleeding turns it bluish-red-violet. That is why we call a black eye a violet.

"Get away with a black eye" means: Something went short but good, but could have ended badly if it had "caught the eye". This refers to the function of the eyelid. This tissue is used to protect our extremely sensitive eye. When we are in a cloud of dust or smoke, we close our eyes and the lid acts like a shield.

The lid protects against sunlight as well as against foreign bodies. We can “blink away” smaller intruders like dirt particles. We move our lids, and the liquid works together with the lid like a damp cleaning rag that wipes the dirt out.

A black eye arises from external pressure, blows, falls or a collision. "Get away with a black eye" can also be metaphorically translated, but refers directly to fights. Anyone who gets a slap on the eye and "only" has a black eye is not in the hospital with a broken jaw.

“Getting away with a black eye” also criticizes the recklessness of putting yourself in situations that can “catch your eye”. If something "catches the eye", we suffer serious damage - physically and as a symbol. In the worst case, we lose our eyesight permanently, with a milder outcome for a short time.

Self-defense coaches and street thugs know how sensitive our eyes are. A targeted blow with the edge of the hand on the eyeball is enough to incapacitate an opponent. Substances such as tear gas, pepper spray or chili also put us out of action for a short time.

A black eye can be accompanied by bruising in the eye, less often by a cut. Hematomas can form in the lid area as well as in the eyeball. Then not only does the tissue around the eye swell, but the white in the eye also turns red.

Eye injuries during sports

Sport is not murder, but an important cause of injuries in and on the eye. Every hundredth eye injury is caused by sport. More than half of them are bruises, then injuries from foreign bodies, followed by infections and irritation, UV rays and chemical substances, external influences and finally through cuts and stitches.

It affects above all competitive athletes, least of all health athletes. Most sports injuries result from sports with objects: soccer, handball, hockey, ice hockey, golf or tennis. Small balls are "number 1 offenders". This is not because they are “eye size”, but they reach a high speed and hit the eye at close range. In short: tennis players are far more likely to injure their eyes than volleyball fans.

Indirect eye injuries during sports are mostly unknown. Jumping, long, high and pole vault increase the frequency of the vibrations in the eye muscles. This can cause bleeding and injure the retina. Even jogging tightens the muscles.

Small balls usually hit the conjunctiva, cornea or rainbow skin, the radiation body or the lens. Footballs, handballs or volleyballs, on the other hand, particularly damage the retina, choroid and optic nerve. Here the impact and rebound of the ball leads to a negative pressure between the lens and the rear section of the eye.

Golf balls with speeds of more than 300 km / h, squash and tennis balls with speeds of more than 250 km / h and badminton balls with speeds of more than 200 km / h look like bullets. Almost ten percent of eye accidents in these sports lead to blindness.

The political situation is deceptive. Football leads in Germany in the ball sports with the highest rate of eye injuries. But that's because it's the most common ball sport. If it is not about the absolute numbers, but about the proportional amount of eye injuries, squash is clearly the eye risk, followed by ice hockey. In squash, 50% of all injuries hit the head and 25% the eye.

For these sports, eye protection should be just as mandatory as mouth protection when boxing. A lot of blindness of ice hockey or squash players could be avoided with face protection. Protection would prevent eye injuries almost 100%.

Basket and volleyball players are particularly at risk of eyelid injuries, as are professional boxers. Boxing professionals regularly suffer from injuries to the chamber angle, lens and retina.

Divers mainly struggle with internal bleeding in the eye. The diving in and out creates a high eye pressure and disturbs the blood circulation, in addition there are nitrogen bubbles during long dives. Bleeding occurs on vessels, retina and choroid and is still one of the "harmless" damages because the nitrogen bubbles can also take your eyesight. Long-term divers also suffer from 50% damage to the retina, according to reliable studies.

It is largely unknown that even exercises that are intended to serve health, such as certain yoga techniques and gymnastics, can have a massive impact on the eye. During head and handstand, the so-called candle, ups and downs on the horizontal bar and gymnastics on the bars, blood penetrates the head and thus presses on the eye. Our neck veins have no valves, and when we stand on our heads, the blood flows freely.

Rides and extreme sports are even more underestimated than the influx of blood in gymnastics. Overhead rides are booming, "Mondlift" or "Enterprise" provide a kick by the passengers turning, in cabins or just on the seat until they are head down. This guarantees not only thrill, but the blood rises into the head and flows back just as quickly when the seat is back in the normal position.

These rides compete with extreme sports like bungee jumping. Bungee jumping in turn poses a high risk of retinal bleeding and blindness.

Internal pressure and illness

Internal pressure causes bleeding in the eye and can cause blood vessels to burst. The main cause is increased blood pressure on the eye. When we sneeze or cough heavily, the internal pressure in the body increases - as does when we lift heavily. Pressure then tears vessels from which blood emerges and flows into the eyes.

Diseases also trigger such internal bleeding, especially conjunctivitis. If the eyes are irritated by such an infection, veins can become porous, tear and burst. Diabetes mellitus can also indirectly lead to eye bleeding because too much sugar collects in the vessels.

Blood thinners and anticoagulants sometimes lead to spontaneous bleeding. In the eye, this hardly shows up as open bleeding, but mostly as a hematoma.

Therapy for bloody eyes

Even laypeople recognize broken veins and bruises in the eye; Doctors usually see if objects triggered the injury. Most of those affected know this themselves - be it that a stone whirled in their eyes, or that they stuck a pencil into their iris.

The situation is different with internal pressure, previous illnesses and injuries to the back of the eye. Blood tests and blood pressure measurements are often required here.

The treatment goes with the cause. In the event of a swelling or bruise, the wound should be cooled, as this narrows the vessels and therefore less blood escapes.

Conjunctivitis, high blood pressure and diabetes mellitus, on the other hand, can be managed with medication. However, if the medication itself is the cause, such as anticoagulants, it is important to change the preparation.

It is not to be trifled with bleeding eyes, after all, the blindness can end up. In addition, blood in the eye sometimes indicates a serious illness such as diabetes mellitus. If high blood pressure is the cause, then this too is occasionally a symptom of serious illnesses, especially at the heart. So a doctor should examine the injury in any case, regardless of whether cut, stab or bruise.

Possible diseases with blood in the eye

The doctor recognizes a basic illness by certain characteristics.

1) Do veins burst without effort or external influence?

2) Do veins burst more often?

3) is nosebleed added to the blood in the eye?

4) Is the person concerned dizzy, do they feel "like the flu"?

Then the blood in the eye indicates an illness, for example atherosclerosis, hypertension, a coagulation disorder or diabetes.

How dangerous are broken veins?

Broken veins in the eye without serious illnesses in the background are harmless - medically speaking, these are small vascular injuries. Once it has been clarified that there are no other symptoms, such injuries heal quickly on their own. (Dr. Utz Anhalt, Dipl.Päd. J.Viñals Stein)

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dr. phil. Utz Anhalt, Barbara Schindewolf-Lensch


  • Karl-Uwe Marx: Complementary Ophthalmology, Hippocrates Verlag, 1st edition 2005
  • Melvin I. Roat: Subconjunctival Bleeding, MSD Manual, (accessed August 26, 2019), MSD
  • Franz Grehn: Ophthalmology, Springer Verlag, 29th edition, 2005
  • Gerhard K. Lang, Gabriele E. Lang: Ophthalmology, Georg Thieme Verlag Stuttgart, 1st edition, 2015

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