Suddenly noticing black spots floating in your vision, a reddish haze or unexpected blurring in one eye can be worrying.
These symptoms may indicate bleeding inside the eye, particularly in the retina or the vitreous gel that fills the eye.
Not all eye bleeding is serious. A red patch on the white of the eye is usually harmless and does not affect vision.
Bleeding inside the eye is different. It needs an immediate retinal examination to find the cause.
Sudden floaters, a dark shadow or an unexplained reduction in vision should be assessed urgently by an ophthalmologist.
What Is Eye Bleeding?
Eye bleeding is bleeding from a blood vessel in or on the eye. Where the blood collects decides how serious it is.
Type | Where the blood is | What you notice | Urgency |
Subconjunctival haemorrhage | Under the clear surface layer of the white of the eye | A bright red patch; vision stays normal | Usually harmless; clears in a few days to a few weeks |
Hyphaema | In the front of the eye, between the cornea and the iris | Blood in front of the coloured part of the eye, blurred vision | Urgent, usually after an injury |
Retinal haemorrhage | In or on the retina | Blurred or patchy vision, or no symptoms | Needs a retinal examination without delay |
Vitreous haemorrhage | In the vitreous gel that fills the eye | Sudden floaters, a red or dark haze, blurred vision | Needs immediate retinal examination |
Key Note – Only an eye examination can confirm where the blood is and why it is there.
What Are the Symptoms of Bleeding Inside the Eye?
- Sudden floaters
New dots, threads or cobweb-like shapes, sometimes many at once.
- A red or dark haze
Vision may take on a reddish tint.
- Blurred vision in one eye
Usually painless, ranging from mild haze to severe loss of vision.
- Shadows or dark patches
Part of the vision may look blocked.
- Vision worse in the morning
Blood spreads while lying down and settles lower once you are upright. - No Symptoms
Small retinal haemorrhages may be discovered during a routine dilated retinal examination.
This is particularly relevant for patients with diabetes or hypertension.
Some bleeding causes no symptoms. Bleeding inside the eye is often painless. Do not wait for pain before seeking an examination.
What Causes Retinal and Vitreous Bleeding?
According to EyeWiki, published by the American Academy of Ophthalmology, three causes account for 59% to 88.5% of vitreous haemorrhage: proliferative diabetic retinopathy, posterior vitreous detachment with or without a retinal tear, and eye injury.
- Diabetic retinopathy
Fragile new vessels on the retina can bleed into the vitreous.
- Posterior vitreous detachment and retinal tears
As the vitreous gel separates from the retina with age, it can tear the retina and a blood vessel with it.
- Eye injury
A blow to the eye can cause bleeding at any level of the eye.
- Retinal vein occlusion
A blocked retinal vein leaks blood into the retina. (LINK AKIO PAGE)
- High blood pressure
Long-term raised pressure damages the small vessels of the retina.
- Wet age-related macular degeneration
Abnormal vessels under the macula can bleed.
- Bleeding in the brain (Terson syndrome)
A brain haemorrhage can cause bleeding inside the eye.
- Blood disorders
Rarer causes include sickle cell disease and clotting problems.
Blood thinners and aspirin are not thought to cause bleeding on their own. They can make bleeding from an existing problem worse.
Also Read: Eye Floaters: When Are They Normal and When Could They Be a Sign of Retinal Detachment?
Can Blood Thinners Cause Eye Bleeding?
Anticoagulants and antiplatelet medicines can increase bleeding risk or severity in some circumstances.
However, eye bleeding should not automatically be attributed to these medicines without examining the eye.
Never stop aspirin, anticoagulants or other prescribed blood-thinning medicines without advice from the prescribing doctor.
When Is Eye Bleeding an Emergency?
Seek immediate eye assessment if you notice:
- A sudden shower of new floaters
- Floaters with flashes of light
- A dark curtain or shadow across the vision
- A sudden drop in vision
- Blood in the front of the eye after an injury
- Significant pain or redness with reduced vision
A retinal tear or detachment may be present even when the eye is not painful.
Arrange a timely eye check if:
- You have diabetes or high blood pressure, even with normal vision
- A red patch appears after an injury
- You take blood thinners and notice any change in vision
How Is Bleeding Behind the Eye Diagnosed?
- Symptom history and vision test
When it started, which eye, any injury, and any diabetes, blood pressure or medicines.
- Dilated retinal examination
To find the source of the bleeding.
- B-scan ultrasound
When blood blocks the view, ultrasound shows whether the retina is torn or detached behind it.
- OCT scan
Detailed images of the macula once the view clears.
- Fluorescein angiography
A dye test that shows leaking or abnormal vessels.
- Blood pressure and blood tests
Checks for diabetes, blood disorders and raised blood pressure.
What Is the Treatment for Bleeding Behind the Eye?
Treatment depends on the cause, not just the blood.
Small bleeds often clear on their own as the eye absorbs the blood. The cause still needs treatment to prevent further bleeding.
- Observation and rest
Limiting strenuous activity and keeping the head raised helps the blood settle so the retina can be seen.
- Laser photocoagulation
Seals retinal tears and shrinks abnormal vessels, lowering the risk of further bleeding.
- Anti-VEGF eye injections
Shrink abnormal vessels in diabetic retinopathy, vein occlusion and wet macular degeneration.
- Vitrectomy
Surgery to remove blood that does not clear, or to repair a retinal tear or retinal detachment found behind it.
- Control of the underlying condition
Blood sugar, blood pressure and cholesterol, managed with your physician.
A red patch on the white of the eye needs no treatment. Lubricating drops can ease mild irritation.
Can Eye Bleeding Cause Permanent Vision Loss?
Yes, in some cases.
The risk depends on the underlying condition.
For example:
- A retinal tear may progress to retinal detachment.
- Advanced diabetic retinopathy can cause repeated vitreous haemorrhage or tractional retinal detachment.
- Retinal vascular disease can damage the macula.
- Wet AMD can cause scarring and central vision loss.
Timely examination helps identify which patients require urgent treatment.
Retina Specialists in Delhi
- Medical Director and Padma Shri awardee Dr Atul Kumar leads AKIO’s retina team, with 41+ years of retinal expertise and experience as former Chief of the Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi.
- Dr Aman Kumar, Senior Consultant Vitreo-Retinal and Cataract Surgeon, is an AIIMS New Delhi alumnus and PGIMER Chandigarh Gold Medallist whose work includes diabetic retinopathy, retinal detachment and retinal surgery.
AK Institute of Ophthalmology (AKIO), Safdarjung Enclave, New Delhi evaluates bleeding inside the eye with dilated retinal examination, OCT, widefield imaging and ultrasound, and treats the cause with laser, intravitreal injections or vitrectomy as required. Together, AKIO’s retina team provides specialist evaluation supported by advanced retinal imaging and surgical technology in Safdarjung Enclave, New Delhi.
For patients looking for a retina specialist in Delhi after sudden floaters or blurred vision, the first step is a dilated retinal examination, with ultrasound if blood blocks the view, to find the source of the bleeding.
Contact AKIO for retinal emergencies.
About the Author: Dr Aman Kumar
Dr Aman Kumar is a Senior Consultant Vitreo-Retinal and Cataract Surgeon at AK Institute of Ophthalmology (AKIO), New Delhi. He is an alumnus of AIIMS New Delhi and a Gold Medallist from PGIMER Chandigarh, where he completed his MS and then did his senior residency at the Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS. His clinical work covers complex retinal conditions, including retinal detachment, diabetic retinopathy, macular disorders, and uveitis. He performs 3D vitreoretinal surgery and micro-incision cataract surgery
Frequently Asked Questions
Is eye bleeding serious?
It depends on where the blood is. A red patch on the white of the eye is usually harmless; bleeding inside the eye needs immediate examination.
Can bleeding inside the eye clear on its own?
Small bleeds often clear over weeks as the eye absorbs the blood. The cause still needs to be found and treated.
Does a red spot on the white of the eye affect vision?
No. A subconjunctival haemorrhage sits on the surface of the eye and clears in a few days to a few weeks without treatment.
Can high blood pressure cause eye bleeding?
Yes. It can cause a red patch on the white of the eye and, over time, damage retinal vessels and cause bleeding inside the eye.
Can I travel with bleeding inside the eye?
Travel by air, car or train to see a retina specialist is not restricted.
