It may seem like something out of fiction, but people can indeed cry blood. This rare medical phenomenon, known as haemolacria, can be startling and alarming to witness. This article clarifies what haemolacria involves and explores its various underlying reasons.
What Is Crying Blood?
Crying blood, or haemolacria, refers to a condition where a person’s tears contain blood. This can range from a subtle pinkish tint to tears appearing entirely composed of blood. The red discharge is a combination of blood and the fluid that normally makes up tears. The presence of blood can originate from any part of the eye’s surface, the tear system, or surrounding structures.
Haemolacria is a rare occurrence, and while it might resolve on its own, it is considered a symptom of another condition rather than a standalone disease. While often not dangerous in itself, it signals that a medical evaluation is warranted.
Common Causes of Bloody Tears
Haemolacria can stem from various underlying medical conditions and external factors. Local eye conditions are a common cause, where trauma to the conjunctiva—the clear protective layer over the white of the eye and inside the eyelids—can lead to bleeding. Injuries, including cuts, ruptures, or eye surgeries, can cause blood vessels in this highly vascular tissue to bleed, mixing with tears. Inflammation of the conjunctiva (conjunctivitis) or eyelid (blepharitis) can also result in bloody tears, sometimes involving bleeding from blood vessels beneath the eye’s surface.
Systemic conditions affecting the entire body can also manifest as haemolacria. Blood clotting disorders, such as hemophilia or thrombocytopenic purpura, can lead to increased bleeding throughout the body, including into the tears. Uncontrolled high blood pressure (hypertension) can put stress on delicate blood vessels, potentially causing them to rupture and result in bloody tears. Tumors or vascular lesions, which are areas of abnormal tissue growth or blood vessel formations, in or around the lacrimal apparatus (tear glands and drainage system) can also be a source of bleeding.
Bloody tears can sometimes be linked to hormonal factors. A phenomenon known as vicarious menstruation can occur in fertile women, where hormonal fluctuations lead to bleeding from areas outside the uterus, including the eyes. This cyclical bleeding typically aligns with the menstrual cycle. In some instances, bloody tears may result from severe nosebleeds (epistaxis), where blood from the nasal cavity is forced backward through the tear drainage system and out through the puncta, the small openings in the eyelids. In a portion of cases, despite extensive investigation, no specific cause can be identified, and these are classified as idiopathic haemolacria.
When to Seek Medical Attention
Experiencing bloody tears warrants prompt medical evaluation, even if the condition appears to resolve quickly. While haemolacria itself is often not dangerous, it can signal an underlying condition that requires diagnosis and treatment. A healthcare provider will conduct a comprehensive eye examination and a general health check to identify potential causes. This evaluation includes reviewing medical history, current medications, and any recent injuries.
Depending on the suspected cause, an individual might be referred to an ophthalmologist, a physician specializing in eye care. Diagnostic procedures can involve a slit lamp examination to inspect eye structures, cultures to detect infections, or imaging tests like a computed tomography (CT) scan of the sinuses or orbit. A nasal endoscopy, using a thin, flexible tube with a camera, might be performed to check the nasal passages for bleeding if a connection to nosebleeds is suspected. Blood tests are also common to rule out systemic issues such as clotting disorders or other conditions. Treatment for haemolacria is always directed at addressing the specific underlying cause identified by medical professionals.