Subconjunctival Haemorrhage and anticoagulants.

[Samazeuilh2]

I noticed I had a subconjunctival haemorrhage in the left eye this morning when shaving. Unfortunately, I had already taken my morning dose of apixaban before I noticed it. I couldn’t get a GP appointment even by phone. Does anyone know what the advice is in this case? Is it recommended to pause the anticoagulant?

[JaneFinn]

Hi Sam, I’m no expert but I can tell you my own experience in case it helps?

A month or two after starting on anticoagulants (rivaroxaban) I had what looked like a broken blood vessel in my eye - I think that’s what a a subconjuntival haemorrhage is? My eye looked like it had bled inside. I panicked a bit, as anticoagulants were new to me but luckily my optician was happy to fit me in the same day. She examined my eye and said nothing to worry about. She also said that the kind of bleed to be concerned about when on anticoagulants (and presumably when not?!) is not where it looks bloody when you look at your eye in the mirror, but where it looks like you’re looking through blood in your vision.

But like I say it’s just my own experience and the advice of one optician How is your eye looking/feeling now? X

Sorry edit to add - no, in my own case I didn’t need to stop the anticoagulant, I did check that.

[Samazeuilh2 in reply to JaneFinn]

Thanks for the reply. I rang the GP and they have no appointments so I’ve been sent to a hospital GP where I am waiting at the moment. It’s reassuring that you were told not to stop. Did you find this was troublesome repeatedly or was it a one-off occurrence?

[JaneFinn in reply to Samazeuilh2]

Oh I’m sorry you’ve had the bother of going to hospital, but I hope you don’t have too long to wait. It was a good idea to ring your GP. Hopefully when you’ve been seen, the outcome is reassuring. Do let us know, won’t you?

No, luckily for me it was a one- off, not had anything like it since, and that was in 2016 Hoping it’ll be the same for you x

[Samazeuilh2 in reply to JaneFinn]

I’m just back from the hospital GP. His advice was to continue with the usual dose of Apixaban, so I’ve just taken it. He also recommends asking my own GP for blood tests, particularly those related to the kidneys, as these might be relevant to the subconjunctival haemorrhage.

[FraserB in reply to Samazeuilh2]

The hospital GP's advice was good and sounds like a thorough doctor. A blood test from your own GP will help rule out any further concerns.

[Samazeuilh2 in reply to FraserB]

He was good. Surprisingly, my own GP doesn’t want to follow his recommendation re the tests!

[JaneFinn in reply to Samazeuilh2]

That’s great to hear, Sam. Well done for getting it checked out, and the blood tests sound a good precaution.

[Samazeuilh2 in reply to JaneFinn]

I’ve just spoken to my own GP to explain and they don’t want to do any blood tests as I had them done in March!

[JaneFinn in reply to Samazeuilh2]

Frustrating!! But I guess that they’d know from those that nothing was wrong with your kidneys in March, so likely still ok now? Luckily it sounds like lots of us have been advised no tests or action needed (other than maybe warning people before they recoil in horror at the bloody eye!) so it should be fine. Maybe if you start getting more of them, the GP might be more in favour of blood tests. But let’s hope it’s a one-off!

[Rosemaryb1349 in reply to Samazeuilh2]

This happens to me occasionally, usually when I've been reading for too long in poor light so got eye strain. It clears in a few days and never affects my vision. I've never stopped or paused my Rivaroxaban when it happens as I'm too worried about risk of stroke.

[Samazeuilh2 in reply to Rosemaryb1349]

Yes, it seems to be the general recommendation unless the eye bleed is very serious.

[FraserB]

I've also had subconjunctival haemorrhages in the last couple years that I've been on Apixaban. The first one happened when I had an appt, about something else, with my GP. He didn't say much and only commented it will go away in a couple of weeks. I also mentioned it my ophthalmologist and she said it can occur spontaneously, especially in people who are taking blood thinners and can look frightening but is harmless. It's when your vision is affected In the eye that is of concern.

[JaneFinn in reply to FraserB]

Oh I find that reassuring to hear, as it tallies with what my ophthalmologist said when it happened to me. (I never asked my GP about it, as the ophthalmologist was so confident it was nothing to worry about.)

[Samazeuilh2 in reply to FraserB]

I was advised to continue with the Apixaban. Hopefully, it won’t worsen the SH. The GP said he couldn’t say whether it was caused by the Apixaban or something completely different,

[WhitstableWanderer]

Hi, I get this periodically, usually when I've not had much sleep. Or sometimes when there's a cold wind. I guess the eye dries up. It doesn't cause me any discomfort, and it's often friends that will say 'what have you done to your eye?' that bring my attention to it as there's no pain or other signals. I use Optrex eye drops to lubricate it as it looks dreadful to others, and it gradually clears within a few days. My anticoagulant is Riveroxiban, which I've been on for nearly six years. Hope that yours clears up soon.

[JOY2THEWORLD49 in reply to WhitstableWanderer]

hi

better for dry eye is

POLYGEL

my eye specialist prescribed it 4 x daily for life.

I failed the blotter test. Nothing in the blotter.

From english descent - York.

cherio Joy. 75 NZ

[Samazeuilh2 in reply to WhitstableWanderer]

Thanks. I also have dry eyes. I was advised by a doctor to use drops with sodium hyaluronate in them (I use Clinitas). It’s important to apply them, particularly, just before going to bed I was told. I find them very effective. I tend to get dry eyes because I do a lot of cycling for exercise.

[southkorea]

it will go in a few days. Get some eye drops

[OldGrit]

I had this about 4 times over the last 15 years and one occurrence was after I started Edoxaban. It took no longer to clear up than the others. I thought nothing of it ..it was gone in 9 days.. I didn’t stop the medication …

[TootingBelle in reply to OldGrit]

I’m on Apixaban and have had a few of these over time. I also have glaucoma and an ophthalmologist at Moorfields told me they are usually harmless and can be caused by heavy sneezing or coughing. No doubt though, we are more prone with blood thinners.

[OldGrit in reply to TootingBelle]

Yes, I agree, although so far I’ve had 3 before edoxaban and 1 after. Sneezing and coughing , yes also swimming underwater while holding breath and weightlifting ! I’m getting more careful/wise as I mature (age!)

[wilsond]

As others have said,not to worry unless affects vision. I had hay-fever recently and rubbed eyes frequently although tried not to.Haemorrhage in left eye,subsided in a few days. Looks worse than it is!

Try to keep eyes moist.

[Samazeuilh2 in reply to wilsond]

Yes, I am using Clinitas which have sodium hyaluronate in them.

[MarkS]

I get these every few years and I'm on warfarin. The last one was only a month ago and took a week to clear up. The warfarin INR was only 2.3 so it wasn't that. I suspect it was from the Pilates class I had just done - particularly downward dog where my head is lower than my hips. That always seems to increase the pressure in my head so I've stopped doing it and do a plank instead.

[hausjac]

Have had these before but the last one now I’m on Apixaban was quite large so I went to my optician just to get it checked. They normally subside quite quickly but this one took 3 weeks as a lot of blood had pooled there. It was no problem but didn’t look pretty!

[Samazeuilh2 in reply to hausjac]

I’ve had them in the past and they can look awful. The present one is mostly on one half of the schlera.

[LaceyLady]

have you thought of asking an optician?

[Samazeuilh2 in reply to LaceyLady]

The GP had a look yesterday. If there is any change of worsening, I’ll go to the optician. Some opticians operate under an NHS “Minor eye conditions” scheme and GP’s often refer you directly to them.

[Dollcollector]

I have had these before and after the anticoagulant. They are harmless. Anyone can get them. They clear up on their own. You don't need any treatment.

[LaceyLady]

I’m having issues with anticoagulant, fell over on holiday and had a ‘massive’ bruise on hip/thigh and haematoma and think I’m over anticoagulanted😵‍💫 Already a ‘bleeder’ so not liking them at mi but no choice or direction 🤷🏼‍♀️