Girl in India Cries Tears of Blood in Rare Medical Anomaly

An 11-year-old girl in India has been found to cry tears of blood in a rare case of haemolacria.

The girl was brought to a clinic in New Delhi by her mother after having blood-tinged tears coming from both eyes for a week. She told doctors the tears would appear spontaneously two to three times per day and were not associated with stress or crying. The bleeding would last for around two minutes.

Doctors found there was no history of illness or medicines that may be involved in the condition. She had suffered from a nose bleed in the last week, however.

The team at the All India Institute of Medical Sciences observed her for two days and found she had two to three bouts of blood-tinged tears every day. Each episode was found to last up to three minutes.

They carried out multiple tests to find the source of the condition. A general examination showed she was of average build with vitals within normal limits. She had 20/20 vision and the pressure inside her eyes was found to be in the normal range.

Blood tests all came back normal and a CT scan also showed no anomalies. The doctors also examined the cells in her tear film and found everything to be normal.

After ruling out all potential causes, they diagnosed the condition as idiopathic, having an unknown cause.

The doctors, who have now published a study of her case in BMJ Case Reports, say the girl represents another instance of haemolacria—"a condition characterized by the presence of blood in tears." This is "one of the most alarming and rare conditions" that is known to have several different causes.

Hemolacria is most commonly associated with bacterial conjunctivitis. However, other cases of haemolacria have been diagnosed in fertile women and are associated with hormones. It can also be a sign of a tumor.

Crying tears of blood, they write, has been known for centuries. In a historical review of cases published in 2011, Ophthalmologist Juan Murube says it was first mentioned in a scientific writing over 1,500 years ago by Byzantine physician Aëtius of Amida. One thousand years later, there is a report of a nun who bled from the eyes every month instead of menstruating. In the 16th century, another case was also reported, with a 16-year-old girl was said to have "discharged her flow throughout the eyes, as drops of bloody tears, instead of through the uterus."

In the BMJ report, doctors say that while the condition is benign, it is associated with more severe diseases, including bleeding disorders. They said a thorough evaluation should be done on patients before the condition is labeled as idiopathic, as they did in this case.