Bloody tears of unknown cause: case series and review of the literature

Ophthalmic Plast Reconstr Surg. 2004 Nov;20(6):442-7. doi: 10.1097/


Purpose: To report 4 cases of recurrent unilateral bloody tears.

Methods: Retrospective case series.

Results: One boy and 3 girls, ranging in age from 6 to 14 years, 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. In all patients, bloody tearing eventually resolved without further sequela. No recurrence has been reported over a follow-up period of 9 months to 11 years.

Conclusions: Bloody tearing is an unusual clinical entity that concerns patients and can perplex physicians. A thorough examination and proper workup are necessary to rule out serious conditions but may fail to determine a cause. These idiopathic cases typically resolve without treatment.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adolescent
  • Blood*
  • Child
  • Diagnostic Techniques, Ophthalmological
  • Eye Hemorrhage / complications*
  • Eye Hemorrhage / diagnosis
  • Eye Hemorrhage / therapy
  • Female
  • Humans
  • Lacrimal Apparatus Diseases / complications*
  • Lacrimal Apparatus Diseases / diagnosis
  • Lacrimal Apparatus Diseases / therapy
  • Male
  • Nasolacrimal Duct / pathology
  • Retrospective Studies
  • Tears*
  • Treatment Outcome
  • Visual Acuity