Unilateral Idiopathic Hemolacria: A Case Report

Purpose: To present a case of a patient diagnosed with idiopathic hemolacria.Case Summary: A healthy 19-year-old man without pre-existing medical conditions presented to the hospital for treatment of intermittent bloody tears from his right eye. The patient reported experiencing bloody tears in his right eye approximately once per month during stressful events for the preceding 6 years. These episodes were associated with ocular pain, right-eye hyperemia, headaches, and nausea. However, these symptoms of bloody tears spontaneously resolved without intervention. Corrected visual acuity in the right eye was 1.0, and the intraocular pressure was 16 mmHg. There were no abnormalities in the ocular appendages, anterior chamber, or eyelids. Nasolacrimal duct probing and irrigation, as well as fundus examination, revealed normal findings. Brain and orbital magnetic resonance imaging did not show abnormalities in the brain or the orbital region, although slight mucosal thickening was present around the right lacrimal gland. Other examinations, including an electrocardiogram, chest X-ray, blood test, and nasal endoscopy, all revealed normal findings.Conclusions: Recurrent bloody tears (hemolacria) occurred in the right eye of a 19-year-old man with no history of trauma, intraocular surgery, or underlying medical conditions. Comprehensive ophthalmic examination and brain and orbital magnetic resonance imaging failed to identify any specific abnormalities leading to a diagnosis of idiopathic hemolacria.