Tears are composed of substances that are very important for lubricating the eye and allowing for adequate visual acuity. On very rare occasions can be accompanied by blood, which is known as haemolacry.
Despite its frequency, cases have been known for centuries. Most are caused by benign tumors, trauma, local infections, and hormonal changes. It is not usually considered serious, but it is advisable to see an ophthalmologist to determine the cause.
What is haemolacria and how does it manifest itself?
This term refers to the emission of tears accompanied by blood. It has been known for many centuries, also having spiritual connotations because it is considered something related to the supernatural.
Even today it raises some doubts in the general population, despite the fact that it is a syndrome well known to ophthalmologists. That doesn’t mean it’s a rare condition.
In most cases these are self-limiting episodes., which also occur periodically. It usually produces no associated symptoms, and many people don’t realize they’re bleeding until they touch the tears or look in the mirror.
Due to the communication of the lacrimal apparatus with the nasal cavity and then with the oral cavity, some patients may report a metallic taste during crying.
Possible causes of haemolacria
In this article, we will only refer to bleeding that accompanies the release of tears.. This does not mean that the eyeball can have lesions in different places which, at one time or another, are liable to bleed in another way.
Menstruation and hormonal problems
According to A magazine study Ophthalmological act which involved the participation of 125 people (men and women) to determine the presence of blood in tears, many had no signs of bleeding, so occult blood had to be determined by chemical methods.
Also, the researchers conducted a special analysis in those women who had menstruation. 18% of women of childbearing age who also menstruated had traces of blood mixed with tears.
But why is it related to hormonal changes? During the evaluation of menopausal patients, none tested positive for occult blood tests. In fact, of the men analysed, only 8% had the phenomenon.
The hypothesis is that menstruation is a condition in which bleeding occurs through various bodily orifices. This includes the eyes, possibly due to a subconjunctival hemorrhage. It usually occurs around menarche and, rarely, in connection with menopause.
Menstruation is associated with the presence of blood in the tears due to underlying hormonal changes.
Neoplasms
Benign neoplasms are a common cause of hemolacria. In the vast majority of cases the tumor cannot be observed.then the doctor will refer to imaging studies to see small lesions.
They usually appear along the lacrimal tract, especially in the duct or sac. The main benign tumors in the area are papillomas and hemangiomas.. The former can have various causes, but the term refers to lesions that have an outer, leafy growth. In fact, they can appear almost anywhere on the body.
Hemangiomas are also quite common and are tumors of the blood vessels. They usually appear isolated and on the skin, although in some cases they extend to internal organs. He pyogenic granuloma it is another benign tumor which, if localized in this atypical ocular site, is associated with the phenomenon.
Hematological diseases
Sometimes, bleeding is the product of blood disorders in which clotting is impaired. This process refers to all those natural measures to ensure hemostasis.
Hemophilia is one such characteristic disease. It has several subtypes, which are A and B, when there is a deficiency of clotting factors VIII and IX, respectively. It is often diagnosed in childhood, as seemingly normal injuries (such as a fall in the park) can cause profuse bleeding.
A case of hemophilia (or another less common bleeding disorder) can cause hemolacria. Local infections (such as conjunctivitis), moderate trauma, and scratching are factors that can promote tearful bleeding.
Inflammation
The presence of inflammatory lesions can cause damage to small blood vessels. The a informative publication of the National Center for Biotechnology Information from the United States. The relationship is established with severe cases of conjunctivitis in which there is ulcer formation.
This phenomenon produces the recruitment of cells of the immune system (such as macrophages, neutrophils and lymphocytes), responsible for the production of local biochemical reactions in the presence of a foreign agent. According to some people authors, haemolacria could be a manifestation of postoperative infections in the eyeballs.
Both surgical interventions and the presence of foreign bodies inside the body can cause inflammatory phenomena. unwanted, which are sometimes treated with drugs to avoid complications. Haemolacria is a signal that alerts the ophthalmologist to possible postoperative complications, perhaps related to the appearance of fistulas.
Diagnosis and treatment of haemolacria
Personal interview and physical eye exam are essential aspects during the medical examination for haemolacria. However, barring cases of external tumors or similar abnormalities, this assessment may be completely normal.
To detect internal anatomical defects, doctors may order computed tomography or nuclear magnetic resonance imaging, with the aim of visualizing small structures that can produce bleeding.
In most cases, no immediate treatment is required.. Therefore, the doctor may opt for a waiting position while awaiting test results. If a cause is identified that needs to be resolved, surgery, anti-inflammatory drugs, or antibiotics may be used.
How common is it?
Haemolacria is very rare. Currently the distribution of the disease is unknown based on gender, race or age.
This is not to say that the possible causes mentioned at the beginning of the article are also rare. Hemophilia, papillomas, conjunctivitis, eye trauma, and eye surgery are common. The detail is that they almost never produce bleeding through tears as an associated symptom.
The rare condition of hemolacria is not always alarming
Haemolacria is a rare condition and should be viewed as a symptom. The doctor who specializes in its diagnosis and management is the ophthalmologist, who on occasion may refer another professional to complete the study.
It is not a serious condition, unless the bleeding is profuse and has significant repercussions on the patient’s life. There are few cases associated with a malignant neoplasm at this site, but when in doubt, it is advisable to schedule a consultation.
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