Bloody tears at the onset of menarche: Ocular vicarious menstruation

Abstract:

Vicarious menstruation is cyclical bleeding from extragonadal sites at the onset of menstruation or within 48 h of its onset. Patient presented with complaint of red tears from the right eye on the 1 ^st day of cyclical menstrual bleeding. Detailed history, thorough examination and evaluation was done to rule out common and rare causes of unilateral bleeding from eye. All parameters were found to be with in normal limits. After excluding other causes, diagnosis of ocular vicarious menstruation was made. She was counseled for conservative treatment and to be in follow up. Patient had repeated episode of hemolacria on subsequent cycles with lesser bleeding. Ocular vicarious menstruation has been reported in middle aged women but rarely in younger children. Multidisciplinary team work is required for diagnosis and management of such cases.