(BMJ)—A 15-yo otherwise healthy girl presented w/ a 1-mo hx of intermittent bilateral bloody tears that began spontaneously w/o hx of trauma. Exam: visual acuity 20/20 bilat; eyelids, conjunctivae, intraocular pressure, fundi, lacrimal sac areas all WNL. Labs: CBC, coag panel, LFTs all WNL. Orbital CT neg. What is the dx?
Idiopathic hemolacria
Conjunctival telangiectasia
Retrograde epistaxis
Lacrimal sac tumor
Endometriosis
You are correct. Idiopathic hemolacria is a rare dx of exclusion. Before labeling as idiopathic, thorough clinical, imaging, and lab evaluations are required. Possible causes for hemolacria include trauma, vascular tumors of the ocular surface, lacrimal system dz, retrograde epistaxis, bleeding disorders, endometriosis, psychogenic causes, and medications. This pt had spontaneous improvement after 8mo.

BMJ Case Reports 2016; doi:10.1136/bcr-2016-218342

By vgreene, 3 April, 2017

qd

By vgreene, 3 April, 2017

ICS

By vgreene, 3 April, 2017

bid

By vgreene, 3 April, 2017

TBD

By vgreene, 3 April, 2017

N/A

By vgreene, 3 April, 2017

HFA

By vgreene, 3 April, 2017

DPI