Crying blood is a rare but documented medical phenomenon that can be startling to witness. It involves tears tinged with blood or entirely composed of it. While alarming, it is typically a symptom of an underlying issue rather than a standalone disease. This article explores what crying blood looks like, its causes, and when to seek medical attention.
Understanding Crying Blood
Crying blood is medically termed hemolacria. This phenomenon involves tears mixed with blood, ranging from a faint reddish tinge to appearing entirely red. The blood can originate from anywhere along the eye’s surface, the tear system, or surrounding structures. In most cases, hemolacria affects only one eye and often resolves on its own.
It is important to differentiate hemolacria from other conditions where blood appears on or around the eye, such as a subconjunctival hemorrhage (a burst blood vessel on the eye’s surface). While hemolacria involves blood mixing with tears, other factors like certain eye drops or severe irritation can cause tears to appear reddish without actual blood. Hemolacria is not inherently dangerous, but it indicates an underlying condition requiring evaluation.
Underlying Causes
Numerous medical conditions can lead to hemolacria, originating from local eye issues or more widespread systemic diseases. Trauma to the eye area is a common cause, where a cut or rupture in the conjunctiva, the protective layer over the white of the eye and inside the eyelids, can cause blood to mix with tears. Injuries to the eyelid or the punctum, the small openings that drain tears, can also result in bloody tears. Surgical procedures involving the conjunctiva may also induce hemolacria.
Inflammation of eye structures, such as conjunctivitis or blepharitis (eyelid inflammation), can cause hemolacria. Severe inflammation can lead to tissue erosion, allowing blood to leak and mix with tears. Certain types of severe viral or bacterial conjunctivitis, including hemorrhagic conjunctivitis, are known to cause blood-stained tears. Growths on the conjunctiva, including benign lesions like pyogenic granulomas or malignant melanoma, can also lead to bleeding.
Disorders affecting the body’s blood clotting ability, such as hemophilia or thrombocytopenic purpura, can manifest as hemolacria. High blood pressure can also contribute, as increased pressure may cause vessels to bleed, potentially pushing blood into the tear ducts from the nasal cavity. Nosebleeds, or epistaxis, can cause bloody tears when blood flows retrogradely through the nasolacrimal ducts and emerges from the puncta.
Hormonal fluctuations can also be a factor, particularly in a rare phenomenon known as vicarious menstruation. These cases, typically seen around menarche or menopause, involve endometrial-like tissue outside the uterus bleeding cyclically, sometimes manifesting as bloody tears. Although rare, the bleeding is usually painless and temporary. Sometimes, the cause remains unidentified, termed idiopathic. Psychological factors, including stress or anxiety, have also been suggested as potential triggers.
When to Seek Medical Help
If you or someone you know experiences bloody tears, it is important to seek medical attention. While hemolacria is not inherently dangerous and may resolve spontaneously, it can indicate a more serious underlying health issue requiring diagnosis and appropriate management. A healthcare provider will conduct a comprehensive eye examination and a general health check to identify the source of the bleeding.
During the evaluation, the doctor will inquire about medical history, current medications, and any recent eye injuries or other bleeding. They may perform tests such as probing and irrigating the tear drainage system, taking cultures for infections, or conducting imaging studies like a CT scan of the sinuses. Blood tests may also be ordered to assess for blood disorders or other systemic conditions. Treatment for hemolacria depends entirely on addressing the specific underlying cause discovered during the medical evaluation.