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Epistaxis Complicated by Hemolacria: A Case Report.

Anne E Drake¹, Clifford D Packer^2,3

¹Case Western Reserve University School of Medicine, Cleveland, OH Aed65@case.edu.

Clinical Medicine & Research

|August 21, 2020

Summary

Hemolacria, or bloody tears, can occur after nasal tamponade for nosebleeds. This rare condition often resolves with conservative treatment, suggesting a link to specific anatomical variations in the lacrimal system.

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Area of Science:

Ophthalmology
Otorhinolaryngology

Background:

Hemolacria is a rare complication associated with epistaxis (nosebleeds).
Nasal compression or tamponade is a common treatment for epistaxis.

Observation:

An 81-year-old male with end-stage renal disease developed hemolacria after nasal tamponade for persistent epistaxis.
The patient was treated with a "Rhino Rocket" nasal tamponade device.
Hemolacria resolved following intranasal oxymetazoline treatment.

Findings:

Hemolacria post-nasal tamponade is hypothesized to result from retrograde flow from inferior nasal turbinates to the lacrimal system.
Anatomical connections via Hasner's and Rosenmüller's valves may facilitate this retrograde flow.
Predisposition to hemolacria may be linked to congenital absence or acquired incompetence of lacrimal valves.

Keywords:

Anatomy Hemolacria Nasolacrimal duct

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Implications:

Physicians should recognize hemolacria as a usually self-limited complication of epistaxis treatment.
Conservative measures can effectively manage hemolacria in the context of nasal hemorrhage.
Awareness of potential anatomical predispositions is crucial for understanding hemolacria occurrence.