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Blood-stained tears-a red flag for malignancy?

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Blood-stained tears (haemolacria) can signal underlying malignancy. This study found 8% of patients with haemolacria had cancer, highlighting its importance as a diagnostic red flag.

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Area of Science:

  • Ophthalmology
  • Oncology
  • Pathology

Background:

  • Blood-stained tears, or haemolacria, can be a rare indicator of occult malignancy within the lacrimal drainage system.
  • This study investigates the causes of haemolacria, focusing on the potential link to malignancy.

Purpose of the Study:

  • To review and analyze data on patients presenting with blood in their tears.
  • To identify the underlying causes of haemolacria, with a specific focus on detecting malignancy.

Main Methods:

  • Retrospective analysis of patient data collected over a 20-year period from a single tertiary ophthalmic hospital.
  • Inclusion criteria: patients presenting with blood in their tears.

Main Results:

  • 51 patients were identified, predominantly female (58%) with a mean age of 55 years. Most cases (96%) were unilateral.
  • The most frequent diagnoses included lacrimal sac mucocele (16 patients) and conjunctival vascular lesions (4 patients).
  • Malignancy was diagnosed in 8% of patients (4/51), including lacrimal sac transitional cell carcinomas and chronic lymphocytic leukemia. Tumors were identified in 18% of cases.

Conclusions:

  • Haemolacria serves as a significant red flag for malignancy, present in 8% of cases studied.
  • A comprehensive clinical examination, including lid eversion, is crucial for identifying localized causes in 27% of patients.