A mysterious case of red tears

Indian clinicians have described their treatment of a woman who presented to hospital with red tears in BMJ Case Reports.

The authors highlighted that drops of blood were coming out of both eyes of the 25-year-old patient when she arrived at the emergency department.

There was no injury to either eye and the patient’s visual acuity was 6/6. A systemic examination was normal.

The patient reported a similar episode one month before when she also had mild nasal bleeding. Further questioning revealed that the patient was menstruating on both occasions.

After excluding other causes of blood in tears, the clinicians diagnosed the patient with ocular vicarious menstruation.

She was prescribed oral contraceptive pills and reported no further episodes at a three-month follow up.

The authors described bleeding tears as an “alarming clinical entity.”

“In our patient, the fact that ocular bleeding was periodical, used to occur only during menstruation from both the eyes raised the suspicion of vicarious menstrual bleeding. Also, after hormonal treatment, there was no recurrence of such episode,” the clinicians shared.