Haemolacria (bloody tears): A perplexing symptom: A report of two cases

Abstract

We present two cases of a boy and a girl (both aged four years) who presented with bloody tears. (haemolacria). The boy initially presented with cough, catarrh and three episodes of epistaxis. Full blood count, coagulation profile, bleeding time, blood film picture and X-ray of the postnasal space were normal. He started shedding blood stained tears initially on crying, two weeks later without associated epistaxis. Subsequently the bloody tearing became spontaneous. He was given intramuscular vitamin K and high dose vitamin C. Other relevant investigations to determine the cause could not be done due to financial constraints, however the bloody tearing stopped after two months and has not recurred after being followed up for two years. The second patient, presented with redness of the eyes and yellowish mucoid discharge of six days, lowgrade fever of three days and spontaneous bloody tears from both eyes. There was associated orbital cellulitis and vomiting of nonbloody recently ingested feeds. Blood investigations were suggestive of sepsis and assays of measured clotting factors and coagulation profile were normal. She was managed with antibiotics and improved with resolution of haemolacria which has not recurred during a follow up period of six months.

Keywords: Bloody tears, haemolacria, children.