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ER or Not: Broken Blood Vessel in Eye

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ER or Not: Broken Blood Vessel in Eye

Apr 21, 2023

A broken blood vessel in the eye can look nasty. But is it worth a trip to the ER? Emergency room physician Troy Madsen, MD, talks about when you should seek emergency help and when you can just see your ophthalmologist.

Episode Transcript

Interviewer: It's another edition of ER or Not with Dr. Troy Madsen. Go ahead and play along and see if you know the answer to today's situation. You have a broken blood vessel in the eye and I'm talking about like, you know, sometimes you'll see somebody, they have an eye and there's just like a lot of blood in it, right? Is that a reason to go to the ER or not?

Dr. Madsen: So this is probably not a reason to go to the ER. So if you wake up . . .

Interviewer: But they look nasty.

Dr. Madsen: They look nasty and they look awful. It's kind of like if you get a scratch on your face and you have a Band-Aid, everyone is going to ask you about it. If you have a Band-Aid on your finger, no one ever asks you about it. But if it's in your eye . . .

Interviewer: All about location, yeah.

Dr. Madsen: Yeah. If you get a little bruise on your arm, no one's asking you. If it's a bruise in your eye, everyone is going to mention it. So it's something that draws a lot of attention, but it's not something you really need to go to the ER for.

Broken Blood Vessel Behind Cornea

Now, the one exception to this might be if you get hit in the eye and there's actually blood behind the cornea, so behind that clear part of the eye in front of the iris, the colored part of the eye, and you see a line there that looks really dark, that's more concerning. So that's not behind the white part of the eye, that's behind the cornea and that's called a hyphema. So the reason that's concerning, is that can cause issues with high pressure in the eye and cause staining of the eye, all sorts of things that can be problems, that would be a reason to go to the ER.

But here we're talking more about you waking up in the morning, you've got blood in the white part of your eye in the sclera. And you say, "Wow, this looks awful," probably you don't have to go to the ER. You could probably just go see an ophthalmologist or an optometrist.

Interviewer: All right. And what causes that, do you know?

Dr. Madsen: You know, in most cases I see, it's some kind of trauma. Someone got poked in the eye or they hit something or maybe they were just rubbing their eye too hard and it just caused a little blood vessel to burst. You got to figure those vessels are pretty small, probably doesn't take a whole lot of pressure or trauma to make one of those burst open and that's usually what causes it.

Interviewer: All right. So just to make sure I'm clear, if it's in the white of the eye just go see my own eye doctor. If it's behind the colored part of the eye like a red line or something, that's when I should go to the ER.

Dr. Madsen: Exactly.


updated: April 21, 2023
originally published: August 25, 2017