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Bloody Tears of Unknown Cause: Case Series and Review of the Literature

Ho, Viet H. M.D.; Wilson, Matthew W. M.D., F.A.C.S.; Linder, James S. m.d.; Fleming, James C. M.D., F.A.C.S.; Haik, Barrett G. M.D., F.A.C.S.

Ophthalmic Plastic & Reconstructive Surgery: November 2004 - Volume 20 - Issue 6 - p 442-447
doi: 10.1097/01.IOP.0000143713.01616.CF

Purpose: To report 4 cases of recurrent unilateral bloody tears.

Methods: Retrospective case series.

Results: One boy and 3 girls, ranging in age from 6 to 14 years, reported spontaneous bloody tearing. Workup included probing and irrigation of the nasolacrimal system, blood and coagulation profiles, blood typing, serum hormone levels, conjunctival biopsy, and imaging. All findings were normal and failed to suggest a cause in any of the cases. In all patients, bloody tearing eventually resolved without further sequela. No recurrence has been reported over a follow-up period of 9 months to 11 years.

Conclusions: Bloody tearing is an unusual clinical entity that concerns patients and can perplex physicians. A thorough examination and proper workup are necessary to rule out serious conditions but may fail to determine a cause. These idiopathic cases typically resolve without treatment.

Four cases of spontaneous, recurrent unilateral bloody tearing of unknown cause are described.

Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A.

Accepted May 10, 2004.

Supported in part by an unrestricted grant from Research to Prevent Blindness, Inc., New York, New York, U.S.A.

Presented at the American Society of Ophthalmic Plastic and Reconstructive Surgery Fall Meeting, Anaheim, California, U.S.A., November 2003.

Address correspondence and reprint requests to Dr. Matthew W. Wilson, 956 Court Avenue, Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, TN 38163, U.S.A. E-mail

©2004The American Society of Opthalmic Plastic and Reconstructive Surgery, Inc.