Bloody Tears Research Articles

Bloody tears: Evert before you investigate – A photo essay

Bloody tears: Evert before you investigate – A photo essay

Unilateral Idiopathic Hemolacria: A Case Report

Purpose: To present a case of a patient diagnosed with idiopathic hemolacria.Case Summary: A healthy 19-year-old man without pre-existing medical conditions presented to the hospital for treatment of intermittent bloody tears from his right eye. The patient reported experiencing bloody tears in his right eye approximately once per month during stressful events for the preceding 6 years. These episodes were associated with ocular pain, right-eye hyperemia, headaches, and nausea. However, these symptoms of bloody tears spontaneously resolved without intervention. Corrected visual acuity in the right eye was 1.0, and the intraocular pressure was 16 mmHg. There were no abnormalities in the ocular appendages, anterior chamber, or eyelids. Nasolacrimal duct probing and irrigation, as well as fundus examination, revealed normal findings. Brain and orbital magnetic resonance imaging did not show abnormalities in the brain or the orbital region, although slight mucosal thickening was present around the right lacrimal gland. Other examinations, including an electrocardiogram, chest X-ray, blood test, and nasal endoscopy, all revealed normal findings.Conclusions: Recurrent bloody tears (hemolacria) occurred in the right eye of a 19-year-old man with no history of trauma, intraocular surgery, or underlying medical conditions. Comprehensive ophthalmic examination and brain and orbital magnetic resonance imaging failed to identify any specific abnormalities leading to a diagnosis of idiopathic hemolacria.

Bloody tears: A new option for early diagnosis of endometriosis

Aims/Purpose: To investigate the cytological composition of tears to determine the potential diagnostic criteria of endometriosis.Methods: Tear samples obtained from the lower fornix of the conjunctiva using a glass capillary tube were examined by microscopy in 100 people: 60 healthy women who made up the control group and 40 patients with endometriosis.Results: The proportion of women with endometriosis, in whose tear erythrocytes were determined was significantly higher, 32.5%, compared with the control group ‐ 25.0%. In 69.2% of women with endometriosis, latent haemolacria was detected in the follicular phase of the menstrual cycle, which significantly exceeded the 30.8% of people with erythrocytes in tears detected in the luteal phase. Epitheliocytes were found in tears in 97.5% of patients with endometriosis versus 75.0% of healthy women, at the same time, in 100.0% cases, − in the follicular phase of the menstrual cycle, compared with 74.3% of healthy women in the same phase of the cycle. The proportion of women with epitheliocytes in the tear in the amount of “++” was 56.4%, which was significantly more compared to 20.0% of people from the control group with epitheliocytes in the same amount; at the same time, group accumulations of epitheliocytes were found in 15.0% of patients with endometriosis, which was significantly higher than in healthy women ‐ 8.3%. In 90.0% of cases in the group with endometriosis, glandular cuboidal epithelial cells were found in the tear, morphologically resembling endometrial cells.Conclusions: The revealed features of the cytological composition of tears in patients with endometriosis, which differed from those in the control group, reflected certain links in its etiopathogenesis, so the study of tear parameters can be useful for predicting the prevalence of “endometrioid disease” and developing pathogenetically substantiated treatment.

HEMATOHIDROSIS-A RARE BLEEDING PHENOMENON

Hematohidrosis is a rare clinical condition in which an individual sweats blood. Even though there are several causes, such as systemic diseases, vicarious menstruation, extreme physical activity, psychogenic reasons, and idiopathic causes, acute fear and intensive mental pondering are the most frequent. Bloody perspiration, bloody tears (Hemoclaria), bleeding from the nose, bleeding from the ears (Otorrhoea), and leaking blood from various skin surfaces are all indications and symptoms of this condition. Here, we present a case of hematohidrosis in a 9y old female child with bleeding for two months from her forehead, nose, ear, and vagina, who responded to propranolol.

Bloody tears as initial manifestation of rhino-orbital mucormycosis.

Bloody tears as initial manifestation of rhino-orbital mucormycosis.

Современные подходы к диагностике гемолакрии в педиатрической практике: обзор литературы и клинический случай

The article is devoted to the problem of the occurrence of bloody tears; emphasis is placed on the features of pathology in the pediatric cohort of patients. The aim of the work is to identify the features of modern approaches to the diagnosis of hemolacria in children. The article is based on the analysis of literature data. The authors present up-to-date data on the etiopathogenesis of hemolacria: injuries, operations, inflammatory and infectious processes, anatomical features of the lacrimal apparatus, systemic diseases associated with pathology of the hemostasis system, vascular disorders, psychological genesis, neoplasms, vicarious menstruation, as as taking certain medications. Modern approaches to the diagnosis of hemolacria are discussed. A thorough examination of patients will allow you to correctly determine the tactics of treatment. The article provides information about idiopathic hemolacria, the diagnosis of which requires the exclusion of other causes of bloody tears. Statistical features of idiopathic hemolacria, as well as concomitant conditions are described; the most common are headache, i.e. migraine, epistaxis, hematohidrosis. The review is illustrated by a clinical case of hemolacria in a 13-year-old girl with the development of epistaxis in 1 month. Examination of the patient revealed the idiopathic nature of the pathology. Key words: hemolacria, bloody tears, diagnostics, idiopathic hemolacria, children

Hemolacria in severe Migraine – Case report

Bloody tears or hemolacria mostly occurs in bleeding disorders, infections, and malignant condition of the eyes and surrounding structure. It is very rare to have it in migraine headache. Hereby, we report a case of Hemolacria in a 47 years lady during acute attack of migraine.

A rare complication of hemolacria after Le fort I osteotomy: a case presentation

BackgroundNasolacrimal duct obstruction (NDO) is a common pathology preventing the proper drainage of the tears, and its main symptom is epiphora. Secondary acquired nasolacrimal duct obstruction (SANDO) can be due to a variety of causes including infection, trauma, or neoplasms. It has been reported to occur with different forms of maxillofacial trauma, especially Le Fort II, Le Fort III, naso-orbital-ethmoidal, and orbital floor fractures.Case presentationA 20-year-old Egyptian female presented to correct a facial disharmony due to a cleft lip and palate defect. The patient reported a history of congenital NDO and had deficient lateral nasal walls. Bimaxillary surgery was planned, including a Le Fort I osteotomy for the maxilla and bilateral sagittal split osteotomy for the mandible. The surgery was uneventful, but the patient complained from bloody tears or hemolacria few days postoperatively. This complication began to cease spontaneously after 2 days and completely recovered after 4 days.ConclusionHemolacria is an infrequent finding after maxillofacial surgeries and may be associated with CLP surgeries more than other surgeries. In this case, it was easily managed, and surgeons should be more aware of it to try to prevent its occurrence.

Blood-stained tears-a red flag for malignancy?

Blood-stained tears can indicate occult malignancy of the lacrimal drainage apparatus. This study reviews data on patients presenting with blood in their tears and the underlying cause for this rare symptom. Patients presenting with blood in their tears, identified over a 20-year period, were retrospectively collected from a single tertiary ophthalmic hospital's database and analysed. 51 patients were identified, the majority female (58%) with a mean age of 55 years. Most cases were unilateral (96%) with blood originating from the nasolacrimal drainage system in 53%. The most common diagnosis for blood-stained tears was a lacrimal sac mucocele (n = 16) followed by a conjunctival vascular lesion (n = 4). Three patients had systemic haematological disorders. The rate of malignancy was 8% (n = 4), with 2 patients having lacrimal sac transitional cell carcinomas, one with a lacrimal sac plasmacytoma and the other with chronic lymphocytic leukaemia and bilateral orbital infiltration (with bilateral bloody tears). One patient had a lacrimal sac inverted papilloma, a premalignant lesion. Four patients had benign papillomas (of the lacrimal sac, conjunctiva and caruncle). Haemolacria was a red flag for malignancy in 8% of patients (and tumours in 18% of patients). A thorough clinical examination including lid eversion identified a conjunctival, caruncle, eyelid or canalicular cause in 27% of cases.

A Strange Occurrence of Hematohidrosis: A Case Report From Saudi Arabia

Hematohidrosis is a rare disorder of blood excretion from the eccrine sweat gland not associated with an injury or trauma. Although several hypotheses exist to explain such a condition, the etiology of hematohidrosis remains unknown. Psychological stress is strongly linked to the condition, yet patients may present completely healthy with no identifiable etiology. The diagnosis of hematohidrosis can be difficult and requires the exclusion of bleeding disorders, vasculitis, and other disorders. Here, we present a case of hematohidrosis in a 20-year-old female who had almost weekly bloody tears, as well as gum bleeding, ear bleeding, and epistaxis for the past four months. During hospitalization, the patient was thoroughly investigated for an etiology, but no identifiable cause was found. The patient was diagnosed with hematohidrosis and treated with propranolol. Her condition had improved significantly on follow-up.

Poetry and the Camp: Epiphanic Witness and Ecstatic Cry in the Spanish-Cuban-American War of 1895–98

Poetry and the Camp: Epiphanic Witness and Ecstatic Cry in the Spanish-Cuban-American War of 1895–98

Actinomyces Canaliculitis Complicated by Orbital Pyogenic Granuloma

Abstract A 92 year-old woman with no significant past ocular history presented with a one-year history of bloody tears, pruritus, and an enlarging supero-medial orbital mass with extension through the right upper eyelid punctum. Magnetic resonance imaging of the orbits demonstrated a well-circumscribed, ring enhancing mass of the right anterior supero-medial orbit. Medial orbitotomy and removal of the orbital mass was performed, and histopathology revealed lymphoid proliferation surrounding a microbial infiltrate staining for gram-positive filamentous bacteria with sulfur granules. Overall, the findings were consistent with chronic canaliculitis secondary to Actinomyces species complicated by formation of an orbital pyogenic granuloma. She has had no recurrence of disease at five months of follow-up. To the authors' knowledge, this case is only the second report of pyogenic granuloma as a complication of Actinomyces canaliculitis and the first associated with an orbital mass.

Idiopathic Hemolacria: a case report

Hemolacria or bloody tears is a rare condition resulting from local and systemic causes. Most of the time cause remains unknown and is inferred to be psychogenic in nature. Management includes identification of the cause along with psycho-social intervention. Here I report a rare presentation of bloody tears in a 16 year adolescent female admitted in our inpatient facility with history and discussion.

Quel bilan devant une haemolacria ? À propos d’un cas et revue de la littérature

IntroductionHemolacria is a rare hemorrhagic syndrome characterized by bloody tears. The most common etiologies are inflammation, infection or laceration. However, other rarer diseases may also cause this clinical manifestation. Case reportWe describe the case of a 14-year-old male patient hospitalized for hemolacria. A history of von Willebrand disease was present in his family, diagnosed in his mother and sister, but absent in our patient. A vitamin C dosage was obtained in our patient and revealed scurvy consecutive to malnutrition. After having excluded other bleeding symptoms like bruises we retained vitamin C deficiency as the etiology of the hemorrhagic syndrome. ConclusionBloody tears are a rare clinical manifestation and the etiology may be difficult to determine. Bloody tears are a rare clinical manifestation of hemorrhagic syndrome. To determine the underlying etiology, screening should consider all possible causes including the rarest.

Transitional Cell Carcinoma of Lacrimal Sac Presenting as a Massive Swelling and Dacryohemorrhea

AbstractTransitional cell carcinomas (TCCs) of lacrimal sac are extremely uncommon neoplasms with high degree of invasiveness, local recurrence, and distant metastasis despite an aggressive treatment. They generally present with epiphora and lacrimal mass lesion but rarely dacryohemorrhea or bloody tears. We hereby report a 50-year-old female who presented with complaints of epiphora, blood in tears, and a progressive swelling measuring 8 cm × 5 cm over left lacrimal sac site. Biopsy from the swelling revealed TCC of lacrimal sac. Radiographic imaging showed a localized mass lesion lacrimal sac eroding adjacent structures, left orbital extension, and left cervical lymphadenopathy without any intracranial extension or distant metastasis. She underwent wide local excision of the primary lesion with left orbital exenteration, left partial maxillectomy, left anterior ethmoidectomy, and left forehead flap reconstruction followed by adjuvant conformal radiotherapy to local site to a dose of 60 Gy and ipsilateral neck to 50 Gy. Combined modality therapy showed satisfactory cosmesis and overall improved functionality on her first review at 6 weeks, however she lost to further follow-up. A thorough review of literature reveals that our case may be one of the largest TCC of lacrimal sac ever reported and the third case to present with dacryohemorrhea in world literature till date.

Idiopathic Haemolacria in a 9 Year Old Girl

Haemolacria or bloody tears is a rare clinical condition caused by various ocular and systemic conditions; some cases may be drug-induced and some are idiopathic. We are reporting a case admitted with recurrent bilateral idiopathic haemolacria. A 9-year old girl was admitted in our hospital with complaints of recurrent spontaneous bloody tears from both eyes for 1 month. There were no other bleeding manifestations. Blood stained discharge from punctum was not observed during compression of either nasolacrimal duct. Psychiatric assessment and ENT examination were normal. Further evaluations for underlying causes were unremarkable. There was no abnormality on the ophthalmological and radiological investigations. The patient was diagnosed as a case of idiopathic haemolacria. Patients presenting with complaints of bloody tears should be evaluated with a detailed history focusing on etiologic factors, ocular examination, and nasal and paranasal examination.
 TAJ 2018; 31(1): 70-72

Bloody tears: a case of bilateral ulcerative blepharitis

Chronic blepharitis leading to bilateral ulceration is rare to encounter. A 49-year-old African American female presents with bloody tears, severe pain, and photophobia in both eyes. Clinical presentation called for ulceration on the upper lid margins with excavated wound which bled on gentle rubbing. A systemic health review in combination of the symptoms and clinical picture led to the diagnosis of severe ulcerative blepharitis. Immediate oral antibiotics were started along with topical antibiotic cream. Ulcerative blepharitis can be easily misdiagnosed with sebaceous cell carcinoma. The pathophysiology of ulcerative blepharitis points to synergy between infectious entity and inflammatory aetiology, with either bacterial or fungal microorganisms as the trigger agents. Almost all cases of ulcerative blepharitis should include a dermatological evaluation given there is a strong association between ulcerative blepharitis and atopic dermatitis.

Clinical experience on diagnosis and treatment for malignancy originating from the dacryocyst.

To summarize clinical experience on the diagnosis and treatment for malignancy originating from the dacryocyst. We retrospectively analyzed clinicopathological data from 12 cases that were diagnosed with malignancy originating from the dacryocyst by histopathological examination in our hospital from 2007 to 2017. Of the 12 cases with malignancy originating from the dacryocyst, 7 were male and 5 were female, with a mean age of 53 years (range, 4-81). Clinical manifestations included a mass in the dacryocyst area in 12 cases, epiphora in 9 cases, pyoid tears in 2 cases, bloody tears in 3 cases, and redness and swelling in the dacryocyst area in 2 cases. Lymphoma occurred in six cases, malignant melanoma in three cases, embryonal rhabdomyosarcoma in one case, and squamous cell carcinoma in two cases. Misdiagnosis and missed diagnosis readily occur for malignancy originating from the dacryocyst because its clinical manifestations are diverse. For the suspected patients, it is necessary to perform related examinations. Individualized treatment should be adopted based on pathological types and specific conditions.

A healthy infant with bloody tears: Case report and mini-review of the literature

A 4-month old healthy infant was brought by her parents to the emergency department with bloody tears of three days duration. There was also intermittent yellowish discharge since birth and a history of flu-like symptoms a week prior to presentation. Extensive investigations revealed no infection or other possible etiologies. The patient was treated with antibiotic eye drops and her condition resolved within a three-four days.In the literature, 15 cases with haemolacria of undermined source were reviewed; the median age of onset (12 years), bilateral involvement and female gender were more commonly encountered, and the most common associated illnesses were headache and epistaxis. The condition is self-limiting and spontaneous resolution is seen in majority of cases. Idiopathic haemolacria is a rare condition that can be presumed in patients presenting with bloody tears when all work-up turns to be negative. The condition is self-limiting with spontaneous resolution.

Dissociative Disorders with Haemolacria: Series of Case Reports

Bloody tears (Haemolacria) are a rare symptom that can be caused by local or systemic pathology. It is one of the most alarming symptom in ophthalmology. Besides those, idiopathic cases have been reported. A case of hyperthyroidism where haemolacria was secondary to the condition has also been reported. Haemolacria are also reported as secondary to epistaxis. Psychogenic causes are described including Munchausen Syndrome by proxy. Here we describe a series of four cases of haemolacria along with bleeding from other sites, found as associated features of dissociative disorders. In this series, patients with age ranging from 14-17 years, three of them are female and one male have been included. Examination excluded local ocular and nasal pathology, coagulopathy and hyperthyroidism. In course of their illness, two of these cases met the DSM 5 criteria for both dissociative disorders and conversion disorders, rest of them have been diagnosed as mixed dissociative disorders. After appropriate intervention, three patients recovered completely and in one patient symptoms (also bleeding) recurred on re-exposure to the previous stress factors. We report three cases of Dissociative disorders and one with both dissociative and conversion disorder where bloody tears were one of the feature. To the best of our knowledge this is the first official report of its kind in Bangladesh.J Bangladesh Coll Phys Surg 2017; 35(1): 36-42