Haemolacria: What Can Cause Someone to Cry Blood?

What is Haemolacria?

Hemolacria, dacryohemorrhea, or bloody epiphora means crying tears of blood.¹ Tears of blood are often associated with mythology or demonic possession, especially in horror movies. However, this rare condition has a scientific explanation. 

Haemolacria has a range of causes, from trauma to eye infection, and can be diagnosed by a medical professional. This article details the causes of haemolacria and how it’s diagnosed and treated.

Is Haemolacria a Medical Emergency?

While some causes of haemolacria are benign and resolve without medical intervention, others can be life-threatening. Consulting a doctor will give you the best chance of identifying and treating the underlying cause. 

Diagnosing Haemolacria

If you notice blood coming from your eyes, seek immediate medical attention. Your eye doctor will do a thorough evaluation to diagnose the cause and determine the best treatment. 

Diagnosis may involve several tests:

• Computed tomography (CT scan) to rule out certain causes
• Slit lamp examination to examine the structures of the eye for any defects
• Nasal endoscopy to examine the nasal and sinus passages
• Cultures to detect abnormalities and infections
• Complete blood count to detect any systemic issues

How to Treat Haemolacria

Clinical follow-up is recommended in cases of an idiopathic diagnosis (unknown cause) to ensure the condition resolves. If it persists, further examination will be required.

Your doctor will recommend treatment options depending on the underlying cause of haemolacria. For example, they may recommend blood pressure medications if high blood pressure causes you to cry blood. 

Other common treatments include:

• Prescription medication, such as antibiotic eye drops against infection 
• Flushing the tear ducts to remove the bloody tears 
• Surgery or reconstruction in cases of serious damage or malignant growths

Outlook

Crying blood may sound like fiction, but it’s an actual medical condition. Haemolacria is a rare condition, and many cases are non-life threatening. 

However, seek emergency treatment if haemolacria is accompanied by eye pain and discomfort.

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Crying Blood (Haemolacria) – Causes & Treatment

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What Causes Someone to Cry Blood?

The following are possible causes of blood in your tears:

Conjunctival Injury

The conjunctiva is the protective mucous membrane covering the whites of the eye (sclera). It also lines the inside of the eyelids. 

The conjunctiva is rich in blood supply, and any injury may cause those blood vessels to leak.² The leaking blood mixes with tears, resulting in bloody tears. 

Causes of conjunctival injuries may include:

• Trauma after an accident
• Chemical contact (e.g., silver nitrate)
• Accidental poke
• Pet scratch
• Contact lens removal 

Nose Bleeds

According to research, about 60% of people experience bleeding in their nasal cavities at some point.³ This is known as nose bleeding or epistaxis. 

The nasal cavity is the internal part of the nose. It’s connected to the lacrimal system which produces tears. The tears drain into the puncta, the small holes in the corners of the eyes.

When you have a nosebleed, blowing or pinching your nose may cause reverse blood flow. Blood can enter the tear drainage system and mix with tears, causing them to look bloody.

High Blood Pressure

Uncontrolled hypertension can cause rupturing of the vessels in the conjunctiva and other nasal tissues.⁴ Although rare, the ruptured vessels may drain blood into the eyes, causing tears of blood. The flow of bloody tears will stop as blood pressure comes down.

Severe cases of blood vessel rupture should be addressed immediately to avoid vision loss.

Blood Disorders

People with bleeding issues like hemophilia have an increased risk of developing subconjunctival hemorrhage.⁵ Any hemorrhage in the eye can cause excessive bleeding, which appears as tears of blood.

Anticoagulant medications or blood thinners, such as aspirin, enoxaparin, clopidogrel, etc., can also contribute to excess ocular bleeding, causing bloody tears.

Pyogenic granuloma

Pyogenic granulomas (granuloma pyogenicum) are highly-vascularized and flaky tumors that can affect any body part. They result from injuries, bug bites, or acute inflammation and are prone to bleeding. 

When a tumor affects the conjunctiva, blood from it may mix with normal tears, causing bloody tears.⁶

Lacrimal Sac Malignancy

Malignant cells can grow anywhere in the body, and the lacrimal sac and lacrimal gland are sometimes affected. Someone with malignant cells in the lacrimal sac can have bloody tears.

Any type of ocular malignancy is serious and requires immediate treatment.

Hormonal Changes

According to research, normal menstruation can trigger cyclical bleeding outside the uterus. This is known as vicarious menstruation.⁷ The bleeding can affect the conjunctiva, resulting in tears of blood. 

Vicarious menstruation in the conjunctiva is usually painless and short-lived (seconds to minutes). It involves one or both eyes.

Idiopathic Cause

Some people cry blood without any explanation or medical cause.⁸ However, most idiopathic cases are not serious and resolve without treatment. 

More research is needed to help understand this phenomenon.

Summary

• Haemolacria is the production of tears mixed with blood. 
• The condition has a range of causes, including nose bleeding, conjunctival injury, hypertension, hormonal imbalances, and lacrimal sac malignancy.
• Most causes of haemolacria are mild and resolve without medical intervention, but others can be life-threatening.
• If you notice bloody tears, seek immediate medical attention to rule out serious health conditions.
• Your doctor will recommend treatment options depending on the underlying cause of haemolacria.