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Hint: It may be related to your blood pressure.
The whites of your eyes are rarely pure as snow. No big deal.
A small red dot or teeny-tiny red specks, though? They’re attention grabbing for a reason—and it’s related to your blood pressure.
Each speck represents a blood vessel that’s burst. Most often, the burst happens when your face and body was straining for some reason—like a rough coughing fit, while moving a heavy piece of furniture, or even laughing—and the pressure built up in the eye’s blood vessels.
But a red dot or specks could also be a sign that your blood pressure is high, meaning you might have hypertension. That’s a condition that’s tied to heart disease, which can lead to a higher risk for a heart attack or stroke, according to the American Heart Association.
The specks could also signal diabetes, another health problem that can impact blood vessels.
Usually, these red spots appear out of nowhere, which is what makes them so alarming, says Cynthia Collins, O.D., an optometrist at the America’s Best Contacts & Eyeglasses in North Myrtle Beach, South Carolina.
While scary to look at, however, she says these specks are almost always harmless. And there’s an upside: they get you thinking about your eye health and your overall well-being.
“Your eyes reflect everything else that’s going on in your body,” says Dr. Collins. “If your eye doctor detects blood vessels that are leaking or misshapen, we know that it’s a problem that’s happening throughout the rest of the body as well.”
Take a closer look at what the red dot (or dots) could be trying to tell you.
Message #1: “Dude, You Overdid It”
As mentioned above, there are strange times when modest, temporary physical strain causes a rapid increase in your blood pressure. A tough bout of the stomach flu and a whopper of a sneeze are other examples of the types of strain that set this chain reaction in motion.
The quick increase in pressure breaks one or more of the tiny, delicate veins that are just below the clear surface of the eye and—poof!—a bright-red splotch suddenly shows up.
The medical name for this is subconjunctival hemorrhage. Or, literally, there’s blood under your conjunctiva, which is the clear coating that covers the white part of your eye. But Dr. Collins reassures us that it’s basically just a bruise to the eye.
The really good news is that these spots, while a little disturbing, are harmless and will go away on their own. It takes up to three weeks for the blood to be reabsorbed, so it progresses from a bright-red patch to yellow or green.
You may notice a slight scratchy feeling on the surface of the eye, Dr. Collins says. Here, cool compresses and artificial tears can bring quick relief.
But there should be no pain, discharge, change in vision, or sensitivity to light. Call your eye doctor if you’re experiencing any of those symptoms, or if the color isn’t fading. These could indicate something more serious.
Message #2: “It’s Time to Get Your Blood Pressure Checked”
A red dot that comes and goes is usually not a cause for concern. But if the dot comes back, or comes and goes repeatedly, it may be a sign that your blood pressure is too high.
The only way to know for sure is to call your eye doctor and have them take a closer look and get to the root cause of the leaky vessel, says Dr. Collins. The anatomy of the eye gives eye doctors the unique opportunity to directly view blood vessels, nerves, and other tissue without resorting to surgery.
High blood pressure would be the first suspicion, she says, because it’s so common in the United States. One in three Americans adults has high blood pressure, according to the Centers for Disease Control and Prevention, which lists it as a primary or contributing cause of death for more than 1,100 Americans daily.
This stealthy disease has a gradual, cumulative effect on blood vessels. It causes them to thicken, narrow, and become brittle. Because those tighter passages still have to move the same volume of blood, they’re prone to leaks and bursts.
During an eye exam, your optometrist will check for bulges or weak spots in the lining of your vessels. She’ll also look for curled or misshapen vessels, and she’ll check to see if the ratio between the size of the arteries and the veins is out of balance.
All of those are visible signs of high blood pressure that “can be detected much earlier in the eye than in the rest of the body because they’re exposed [during an eye exam],” says Dr. Collins.
When high blood pressure shows up during an eye exam, your eye doctor will be able to treat any related problems that are affecting your eye health or vision. But you’ll also be referred to your family doctor for a complete checkup and to begin steps to lower your blood pressure.
Message #3: A Different Eye Problem Is Brewing
If the eye exam turns up no signs of high blood pressure, Dr. Collins says the next step is to rule out other eye conditions or health problems.
Diabetes would be one concern. Uncontrolled high blood sugar can cause the tiny blood vessels in the retina to swell, weaken, and leak. As with high blood pressure, if your eye doctor suspects diabetes, they will be able to treat related eye issues, but they’ll also have you see your family doctor for a complete diagnosis and treatment plan.
Your doctor may also want to rule out some genetic clotting disorders that can cause blood vessels to be more prone to breaking easily.
If the red spot is coupled with any discharge, that hints at an underlying bacterial or viral infection that’s affecting your blood pressure. A much less common cause of a bloody spot in the eye is something called a conjunctival hemangioma, which is a noncancerous tumor caused by abnormal growth of blood vessels. This disorder is closely related to the blemish known as a strawberry birthmark.
“When there is a red spot that does not go away, or it gets larger, it should be checked,” advises Dr. Collins. “It may actually be blood vessels growing where they’re not supposed to be.”
Bottom line: if you have any concern about a red dot that shows up on your eye, call your eye doctor.
“There are different possibilities,” says Dr. Collins. “Come in and ask questions, because your optometrist is here to reassure you.”