Blood Inside the Eyeball: What You Need to Know

25 Mar 2024

Waking up to find blood in your eye can be a terrifying experience. While the sight of blood inside the eyeball—medically termed hyphema—is alarming, it’s crucial to understand that it’s not always a medical emergency. However, it always warrants a visit to an eye doctor or the emergency room to determine the cause and appropriate treatment.

Hyphema occurs when blood accumulates in the anterior chamber of the eye, the space between the cornea (the clear front surface of the eye) and the iris (the colored part of the eye). This typically happens due to trauma to the eye, causing blood vessels in the iris or other structures to leak. The severity of a hyphema can range from a small amount of blood that looks like a faint shadow to a large pool of blood that completely obscures vision.

Several factors can lead to blood inside the eyeball. The most common cause is blunt force trauma to the eye, such as getting hit with a ball, fist, or other objects. Falls, motor vehicle accidents, and sports injuries are common culprits. Other potential causes include:

Certain eye surgeries
Blood clotting disorders
Certain medications, such as blood thinners
Eye tumors (rare)
Neovascularization (abnormal blood vessel growth) on the iris

Recognizing the symptoms of hyphema is crucial for seeking timely medical attention. While visible blood in the eye is the most obvious sign, other symptoms may include:

Blurry vision
Pain in the affected eye
Sensitivity to light (photophobia)
Headache

If you suspect you have blood inside your eyeball, it is essential to seek medical attention immediately. Prompt diagnosis and treatment are vital to prevent potential complications, such as glaucoma (increased pressure inside the eye) and permanent vision loss.

Complications of Hyphema

While many cases of hyphema resolve with minimal or no long-term effects, it's important to be aware of potential complications, particularly if left untreated:

Complication	Description
Glaucoma	Blood in the anterior chamber can obstruct the normal flow of fluid, leading to increased pressure inside the eye. This pressure can damage the optic nerve, potentially resulting in vision loss.
Corneal Staining	In some cases, blood cells can stain the cornea, leaving behind a permanent brown discoloration that can affect vision.
Vision Loss	Untreated hyphema, particularly if it's severe or accompanied by complications like glaucoma, can lead to permanent vision impairment.

When to Seek Emergency Care

While all cases of hyphema warrant a doctor's evaluation, some situations require immediate medical attention. Seek emergency care if you experience:

Sudden vision loss
Severe eye pain
Nausea or vomiting accompanying the eye symptoms
Blood filling the entire anterior chamber of the eye
Hyphema that doesn't improve with initial treatment

Diagnosis and Treatment

Diagnosing hyphema typically involves a comprehensive eye exam. Your eye doctor will assess your vision, examine the affected eye using a slit lamp (a specialized microscope), and may measure the pressure inside your eye. Treatment for hyphema depends on the severity and underlying cause but generally focuses on promoting blood reabsorption, controlling eye pressure, and preventing complications.

Treatment options may include:

Eye drops (corticosteroids to reduce inflammation, eye drops to dilate the pupil and help with pain)
Medications to control eye pressure
Rest and activity restriction
Wearing an eye patch to protect the eye
Surgery (in rare cases, to remove blood from the eye or address underlying conditions)

Preventing Hyphema

Many cases of hyphema are preventable, especially those caused by trauma. Here are some tips to reduce your risk:

Wear protective eyewear during sports and activities that pose a risk of eye injury
Use appropriate safety equipment at work, especially if your job involves hazards that could impact your eyes
Secure your home to prevent falls, particularly for young children and older adults
Manage underlying health conditions like high blood pressure and bleeding disorders in consultation with your doctor

Blood inside the eyeball, while concerning, is a treatable condition. Understanding the causes, symptoms, and importance of seeking prompt medical care can help protect your vision and overall eye health. Remember, early intervention is key to preventing potential complications and ensuring the best possible outcome.