Eyes, menstruation and endometriosis

Area of Science:

• Ophthalmology
• Gynecology
• Reproductive Medicine

Background:

• Vicarious menstruation involves cyclical bleeding outside the uterine cavity.
• Haemolacria (blood in tears) is a rare symptom, sometimes linked to menstruation or endometriosis.
• Ocular endometriosis, where endometrial-like tissue affects the eye, is exceptionally rare and difficult to diagnose via biopsy.

Purpose of the Study:

• To review literature on ocular endometriosis and vicarious menstruation.
• To discuss clinical presentation, diagnosis, and treatment of ocular endometriosis and haemolacria.
• To explore the connection between ocular symptoms and endometriosis.

Main Methods:

• Literature review of ocular endometriosis and vicarious menstruation cases.
• Analysis of clinical presentation, diagnostic challenges, and treatment options.
• Discussion of potential pathophysiological mechanisms, including lymphatic/hematogenous spread and hormonal receptor presence.

Main Results:

• Ocular endometriosis is rare, with diagnosis often challenging due to anatomical difficulties in obtaining biopsies.
• Haemolacria can be a sign of vicarious menstruation, potentially linked to endometriosis or hormonal changes in conjunctival vasculature.
• Clinical correlation of haemolacria with the menstrual cycle is crucial for diagnosis.

Conclusions:

• Diagnosis of vicarious menstruation can be established through clinical correlation with the menstrual cycle, enabling symptomatic treatment.
• Understanding the link between endometriosis and ocular symptoms is vital for patient management.
• Further research is needed to elucidate the mechanisms and improve diagnostic and therapeutic strategies for ocular endometriosis and vicarious menstruation.