Friday Q & A: Broken Blood Vessels in the Eyes

Closed Eyes by Odilon Redon

Q: Today one of my students said that a couple of days ago she noticed a broken blood vessel in her left eye. This occurred the day after doing inversions in class. She asked me if I thought the inversion caused it. To be honest, I'm not sure, but I suspect it might have. She's been practicing yoga for 3 years and had done inversions before. This is the first time she got a broken blood vessel. Do you have any suggestions? Maybe you could point me towards an article you wrote on this topic. I also get concerned about students who get really blood shot eyes after inversions. Do you think this is a warning sign? Or a problem?

A: Let’s address the question of the broken blood vessel in the eye that showed up the day after inversions were done in class. The situation where a tiny blood vessel in the eye ruptures under the clear part of the eye (the conjunctiva) and causes an area of blood red to appear in the white part of the eye (sclera), either to the right or left of the colored part of the eye, is most commonly known as a subconjuctival hemorrhage. Usually, you don’t know it has happened until you look in the mirror. Because the area of trapped blood is so pronounced, people often worry something really bad has happened. It turns out this condition is not a problem and will usually resolve in one to two weeks. Why so long? Well, the conjunctiva does not reabsorb the blood very quickly, so it takes awhile for the blood to disappear. According to the Mayo Clinic, it is usually a harmless condition, sometimes without an obvious cause, but occasionally associated with a cough or sneeze that causes a blood vessel to break. No specific treatment is recommended, and, as I said already, it usually resolves in a few weeks.

Since most people don’t know they have it until they look in the mirror, usually there are no other symptoms. On occasion, some folks will notice a bit of a scratchy feeling over the surface of the eye. It should not affect your vision, cause any discharge from the eye or cause pain—great news! As to the underlying cause of the broken vessel, sometimes it is not known, but according to Mayo Clinic, any of the following could be a cause: violent coughing, powerful sneezing, heavy lifting, or vomiting. An eye injury such as roughly rubbing the eye, a severe eye infection or a trauma to the eye such as a foreign body in the eye more rarely could be the cause. People are at higher risk for developing a local eye bleed like this if they have diabetes, high blood pressure, blood-clotting disorder or are taking medications like blood thinners or aspirin.

Now, to our student who developed a subconjuctival hemorrhage. I’d certainly check in with them to see if they have any risk factors as listed above. But unless they have this recurring more than once, it is probably not a problem that needs to be further addressed. Could the inversion have lead to this? It could, especially if the student was not doing inversions regularly and was straining to go in, stay in, or come out of the inversions. The pressure that goes towards the head, and therefore the eyes, could mimic the pressure build up of heavy lifting (one of the causes of subconjuctival hemorrhage). In general, doing lots of warm ups that eventually lead to the full inversion may help to prepare the entire body system to work without overworking and prevent such bleeds from happening again.

As for the observations that other students sometimes are noted to have bloodshot eyes after inversions, this again could be a result of the increase in pressure and blood flow towards the eyes from the inverted position. And unless they have risk factors for not doing inversions, good preparation with longer Downward-Facing Dog poses and other milder inverted positions, before doing the full inversions, and not staying long in the full inversions if they are new to them, may reduce the likelihood of this to occur. And consider other reasons for having bloodshot eyes, such as smoking pot (yes, really).

—Baxter

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