Haemolacria: A Novel Approach to Lesion Localization

Abstract

Purpose: To report the use of punctal plugs as a new modality to assist in the localization of lesions providing symptomatic relief in patients with haemolacria during their workup.

Methods: Retrospective case series.

Results: One boy and one girl, ages 16 and 20, respectively, reported spontaneous bloody tearing. Workup included probing and irrigation of the nasolacrimal system, blood and coagulation profiles, blood typing, serum hormone levels, conjunctival biopsy, and imaging. All findings were normal and failed to suggest a cause in any of the cases. Punctal plugs were inserted into each patient’s inferior punctum OS without complication. On initial follow-up visits, each patient reported cessation of bloody tears OS with continued bloody tears OD. Over time, both patients experienced complete cessation of haemolacria in both eyes.

Conclusions: Haemolacria is a condition caused by a group of disorders that result in the production of tears that are partially composed of blood. The large majority of cases result in a specific diagnosis. Only rarely does workup result in undetermined etiology. The novel approach of utilizing punctal plugs in the management of haemolacria may not only provide symptomatic relief for lesions distal to and including the punctum, but also assists in anatomic localization in idiopathic cases.

• Bloody
• haemolacria
• idiopathic
• localization
• plugs
• punctal
• tear

ACKNOWLEDGMENTS

This work was presented in part as a Poster Presentation at The Association for Research in Vision and Ophthalmology (ARVO) Annual Meeting, May, 2011, Ft. Lauderdale, Florida, USA.

DECLARATION OF INTEREST

The authors report no conflicts of interest and have no financial interests to disclose. The authors alone are responsible for the content and writing of the paper.

The authors received an unrestricted grant from Research to Prevent Blindness (New York, NY) to the Hamilton Eye Institute (Memphis, TN).