Haemolacria (Cry Blood): Causes & Treatment

Hummingbird: Bloody tears, or haemolacria, are a real thing. Causes include an injury to the conjunctiva, a bloody nose, blood disorders, high blood pressure and hormonal changes. Although often the condition itself is benign, you should seek immediate medical attention if you discover blood in your tears.

What Is Haemolacria? 

The subject of crying tears of blood sounds like something lifted straight from a fiction — or mythology. And while genres like horror movies have made this a trend, crying tears of blood is a factual condition. The condition is known as haemolacria, or bloody epiphora. 

It is a rare medical condition that causes a person to produce tears that are mixed with blood. Also known as haemolacria, sanguineous lacrimation, sanguineous tears or dacryohemorrhea, it is a symptom of other underlying conditions. While most of these conditions are benign, you are advised to seek medical help if you notice blood in your tears.

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What Causes Haemolacria? 

The presence of blood in your tears could be the result of: 

• Conjunctival injury 
• Blood disorders 
• Conjunctival Injury 
• Nose bleeding 
• Pyogenic granuloma 
• Lacrimal sac malignancy 
• Uncontrolled hypertension 
• Hormones

Conjunctival Injury

The conjunctiva is a clear membrane found on top of the white part of your eye or the sclera. It is full of blood vessels that can sometimes be torn or inflamed, leading to bleeding of the conjunctiva. The blood hemorrhaging from the conjunctival can mix with your tears and give the appearance of bloody tears. 

Blood Disorders

Certain blood disorders like hemophilia can result in bloody tears because of clotting complications. People diagnosed with this condition tend to bruise easily, resulting in haemolacria. Other blood-related conditions treated by blood thinners can also play a contributing role.

Nose Bleeds

Bleeding in the nasal cavity is known as epistaxis. The lacrimal system is responsible for the production and drainage of tears and is closely related to the nasal cavity. When you have a nose bleed and pinch or blow your nose, a reverse blood flow can make its way to your tears, and you will have tears that have blood in them.

Pyogenic Granuloma 

This is a benign but highly vascularized tumor that grows from the lacrimal sac or conjunctiva. Pyogenic granulomas can be caused by bug bites, injury or acute inflammation. In some cases, pyogenic granulomas present during pregnancy because of sporadic changes in hormones. 

Lacrimal Sac Malignancy 

Malignant melanomas can show up in any body part, including the conjunctiva, lacrimal sac or lacrimal gland. People who have lacrimal sac malignancies often deal with blood in their tears. These conditions can have a devastating effect on your overall health and should be treated immediately. 

Uncontrolled Hypertension

Although rare, untreated hypertension (high blood pressure) can cause bloody tears. This happens when blood pressure is so high that it leads to rupturing of the conjunctiva or nasal tissues. However, once the hypertension is under control, the bloody tears should disappear. 

Hormones 

The presence of blood in your tears could be the result of hormonal changes, especially in menstruating women. In these cases, the blood is only found in trace amounts and should go away after the menstruation period has passed.

How Is Haemolacria Diagnosed? 

If you see blood present in your tears, visit a doctor so that you can understand the cause and develop a treatment plan. You are likely to undergo extensive tests and examinations. Any medication prescribed will depend on the underlying factors contributing to blood in your tears.  

In some instances, you may go through imaging tests like dacryoendoscopy to rule out certain causes. Worth noting is that some cases of haemolacria are ruled idiopathic, which means the cause is not detectable at the time of diagnosis. 

Other diagnostic tests for haemolacria include:

• Sinuses CT scan 
• Nasal endoscopy 
• Taking cultures to identify abnormalities 
• Probing the affected area of the eye 

Can Haemolacria Be Treated? 

Treatment options for haemolacria largely depend on the underlying causative factors. Initially, the doctor may just advise you to wait and see if the condition will disappear on its own or how it will progress. 

But the doctor could recommend: 

• Prescription medication like antibiotic eye drops to combat the infection 
• Dilating and flushing to drain tears 
• Stenting — where a tiny mesh is placed into a newly opened artery area to prevent it from narrowing or closing up 
• Surgery or reconstruction 

Haemolacria FAQs 

Is it possible to cry blood? 

Yes, it is possible for blood to mix with your tears. This condition is known as haemolacria. Although the condition is rare, you should seek medical attention to understand why your blood is mixing with tears and how to treat it. 

What causes haemolacria? 

This condition can be the result of various illnesses and medical conditions. Sometimes, blood mixing with tears could be caused by trauma and injury, nose bleeds, hormonal changes, tumors, high blood pressure, and medical conditions like hemophilia. 

Should you see a doctor over bloody tears? 

Yes, you should consult a doctor if you notice blood in your tears. While some causes of haemolacria are simple and fix themselves, others can be life-threatening. Consulting a doctor will give you the best chance of combating the condition. 

References

1. Haemolacria: A Novel Approach to Lesion Localization. (July 13, 2015). National Center for Biotechnology Information.

2. Subconjunctival Hemorrhage. (February 23, 2022). National Center for Biotechnology Information. 

3. What is Haemolacria? (February 21, 2022). National Center for Biotechnology Information.

4. Occult Haemolacria in Females. (August 9, 1991). National Center for Biotechnology Information. 

5. A Review of Diagnostic and Therapeutic Dacryoendoscopy. (November 5, 2019). National Center for Biotechnology Information.