Haemolacria refers to the presence of blood in the tears. Concentrations may be so low that it can only be detected with laboratory testing, or the patient may appear to be bleeding from the eyes due to the high blood content. It usually appears as a symptom of disease, although it can also develop spontaneously in some cases, particularly in fertile women. Research suggests that some women produce some blood in their tears in connection with the hormone cycle, and may be unaware of it because only traces are present.
Injuries to the eye can lead to haemolacria, as the eye or surrounding area may leak blood that mixes with the tears. Tumors and other lesions inside the eye and near the tear ducts are another possible cause. Inflammation and infection are also associated with haemolacria, as they can cause irritation severe enough for the capillaries to start leaking. A physical evaluation may reveal the underlying cause, and treatment should resolve the bloody tears and make the patient feel more comfortable.
Certain systemic infections are also associated with bloody tears. Hemorrhagic fevers like Ebola cause blood vessels to burst, leading to leaks throughout the body. Patients can develop heavy bruising, bleeding from mucus membranes, and haemolacria as their bodies slowly break down as a result of the infection. In these cases, the systemic symptoms, including high fever, disorientation, and bruising, are all clinical signs that may assist with diagnosis.
Visually, this condition can be frightening for people around the patient if enough blood is present to discolor the tears. Dark, bloody tears can be particularly dramatic and people may fear the patient is seriously ill. People who are already in treatment for an issue known to cause bloody tears should report this symptom if it develops, as it may indicate that the treatment is not working or needs to be adjusted. If there is no known cause, a visit to a doctor for evaluation may be advisable.
Some cases of haemolacria have been reported in spontaneous circumstances. Researchers theorize it may be associated with extreme stress or psychological upset in these instances. The link with hormone cycles is another possible explanation; if the bloody tears only appear once or twice, it may be difficult to definitively determine if they're connected with the patient’s endocrine cycle. Studies to determine why some women experience this phenomenon in connection with menstrual cycles haven't been conclusive.