Conjunctival Folliculosis Presenting as Hemolacria

A 13-year-old female reported a one-year history of hemolacria in her left eye following an episode of a migraine attack and anger outburst. Ophthalmic examination revealed inferior fornix follicles with petechia and absent inflammatory reaction. The patient was treated with topical antibiotics, steroids followed by topical 1% cyclosporine and vitamin C. Bloody tear symptoms resolved and no bloody tear was observed for the three months insinuating that conjunctival folliculosis should be considered in the differential diagnosis of hemolacria and entity needs to be differentiated from follicular conjunctivitis. Through this case report we would like to emphasize the importance of the conjunctival folliculosis identification and possibility of shedding a bloody tear in presence of vascular dysfunction. Therefore, necessitate treatment of the benign entity similar to reactive lymphoid hyperplasia.