Haemolacria

Condition of crying tears mixed with blood

Haemolacria is a rare condition characterized by the presence of blood in the tears. This phenomenon can be alarming to both patients and clinicians, as it may indicate underlying ocular or systemic conditions. Haemolacria can occur in one or both eyes and may be associated with other symptoms depending on its cause.

Causes

Haemolacria can result from a variety of causes, which can be broadly categorized into local ocular causes and systemic causes.

Local Ocular Causes

• Conjunctivitis: Inflammation of the conjunctiva can lead to haemolacria, especially if there is significant irritation or infection.
• Trauma: Injury to the eye or surrounding structures can cause bleeding into the tear film.
• Tumors: Benign or malignant growths in the lacrimal apparatus or surrounding tissues can lead to bleeding.
• Surgery: Post-surgical bleeding from procedures involving the eye or eyelids can result in haemolacria.

Systemic Causes

• Bleeding disorders: Conditions such as hemophilia or thrombocytopenia can predispose individuals to bleeding, including in the tear film.
• Hypertension: Severe high blood pressure can cause small blood vessels to rupture, potentially leading to haemolacria.
• Vasculitis: Inflammation of blood vessels can affect the ocular region, leading to bleeding.

Diagnosis

The diagnosis of haemolacria involves a thorough medical history and physical examination. Key steps include:

• Ocular Examination: A detailed examination of the eye using a slit lamp to identify any local causes of bleeding.
• Systemic Evaluation: Assessment for systemic conditions that might contribute to bleeding, including blood tests to evaluate clotting function.
• Imaging Studies: In some cases, imaging such as CT scan or MRI may be necessary to evaluate for tumors or other structural causes.

Treatment

Treatment of haemolacria depends on the underlying cause. Management strategies may include:

• Addressing Local Causes: Treatment of infections, removal of foreign bodies, or surgical intervention for tumors.
• Systemic Treatment: Management of underlying systemic conditions such as hypertension or bleeding disorders.
• Symptomatic Relief: Use of artificial tears or lubricating eye drops to provide comfort.

Prognosis

The prognosis for haemolacria varies depending on the underlying cause. In cases where the cause is benign and treatable, the prognosis is generally good. However, if haemolacria is due to a serious systemic condition, the prognosis may be more guarded.

Related pages

• Tears
• Lacrimal apparatus
• Ophthalmology
• Bleeding disorders