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The scariest thing in my life is when he looked at me and said, ‘Mum, am I going to die?’ That right there broke my heart.” ~ Tammy Inman, mother of haemolacriac Calvino

Haemolacria is a condition that causes a person’s tears to be partially or entirely composed of blood. The word means, in the simplest terms imaginable, “bloody tears.” Ophthalmologist Dr. Rex Hamilton says, “That is just a descriptive term of the manifestation of bloody tears. It says nothing about what’s causing it. It’s a one-in-a-million kind of condition.”

Though haemolacria sounds terrifying and certainly LOOKS terrifying in the pictures you might see online if you search for it, it’s generally not life-threatening. It seems to be a symptom that can be caused by a variety of causes. The most prominent seems to be hormones. A study done in 1991 showed that bloody tears occured in 18% of menstruating women, 8% of men (though this was most often provoked by other conditions), 7% of pregnant women, and no post-menopausal women.

It could also be caused by infection or inflammation, such as tuberculosis and scoleral buckle infection. Most commonly it occurs due to the mild eye infection known as bacterial conjunctivitis, in which the haemolacria typically goes away after the infection is treated. Ebola fever can cause blood vessels to burst and leak throughout the body, leading to bruising, bleeding from mucus membranes, and haemolacria as the person’s body slowly breaks down.

Injury to the head or eyes can also cause haemolacria, as well as blood clots, tumors, lesions, environmental damage, and nosebleeds, though oddly enough it also seems to have a psychological factor, as it has been brought on by stress in rare cases.

When haemolacria comes on, doctors will examine the patient to rule out certain causes, but if a cause cannot be found, the patient typically goes without treatment, which makes sense ~ how can a doctors treat someone for something if they don’t know what’s causing it? They are also reluctant to explore the idea that haemolacria might be brought on by torn tear ducts, because it can be harmful.

“There probably is a cause, but it is a small tear duct that is only a millimeter or two or three in diameter. It’s a tube. To get into that tube and examine that tube from one end to the other would cause scarring, and you could lose part of the tear duct. That’s the dilemma that can cause problems, that we will leave someone with a permanent disability,” says James Fleming, an ophthalmologist at the University of Tennessee’s Health Science Center’s Hamilton Eye Institute.

Haemolacria is rare, though it probably won’t seem like it after I tell you about all these people who have had it. First I will begin with the physiological cases, where the haemolacria was brought on by a physical condition.

A couple of examples of haemolacria brought on by menstruation occurred in a sixteenth century nun and a sixteen-year-old girl in 1581. As an injury-induced example, a Canadian man was bitten by a poisonous snake and experienced bleeding from the eyes, painful swelling, and kidney failure as a result of internal bleeding caused by the snake’s venom.

Oddly enough, haemolacria also appears to be brought on by nosebleeds. When an adult tells their child to pinch their nose and tilt their head back to stop a nosebleed, they don’t know that it could be more harmful to the child than letting the blood drip down onto the kid’s shirt (though it does appear decidedly less frightening). Pinching the nose sends the blood through the eyes and occasionally the ears, as was the case in a 56-year-old woman in 2003, who plugged her nosebleed and ended up with bloody eyes and ears.

“Its anatomical basis lies in the intimate connection of nose and eye via the lacrimal apparatus,” said her doctor, Dr. M. Weise. “An increase in pressure within the nasal cavity during epistaxis [nosebleeds]—for example, by pinching or blowing the nose, can cause retrograde flow of blood through the system and thus lead to bloody tears emerging from the ipsilateral eye. As our patient had longstanding perforation of both tympanic membranes, the blood in her nose was also able to travel retrograde via the auditory tube and middle ear into the external auditory canal. This led to the additional bleeding from the right ear.”

A 73-year-old man with low blood pressure caused haemolacria due to plugging his nosebleed in 2012. An eleven-year-old girl suffered from nose and eye bleeds for two years before seeking treatment; the doctors accredited it to hyperaemia (the increase of blood flow to different tissues in teh body, in this case the nose) and increased vascularity (bulging veins) in the nasal cavity.

The only case of psychologically-induced haemolacria I have found was that of a fifteen-year-old girl in November of 1984. The girl was under stress, studying hard for exams, when she suddenly experienced a headache, giddiness, and haemolacria. It had no effect on her vision, and this happened three times before she went in for examination. The haemolacria appeared to have no relationship with her menstruation, there were no physical abnormalities when she was checked, and her family had no history of bleeding disorders. She was given a treatment of Vitamin C and K, as well as injectable B Complex, but the treatments were ineffective. The girl suffered from hysterical traits, however, and the doctors finally concluded that this must be the cause of her haemolacria.

More mysterious than ever are the cases that seem to have absolutely no reason behind them. “What’s really rare is to have a child like this,” the director of the University of Tennessee’s Hamilton Eye Institute, Dr. BarrettG. Haik, said. “Only once every several years do you see someone with no obvoius cause.” This spontaneous haemolacria has not yet been explained, and I’m doubting that it will be any time soon (though I think observing the tear ducts would be a good place to start as soon as we have better technology to do that).

Haik, Fleming, and their colleagues did a study on three girls and a boy who were bleeding from the eyes, but all of their physical studies came out inconclusive. They ultimately gave this report: “In all patients, bloody tearing eventually resolved without further sequela. No recurrence has been reported over a follow-up period of nine months to eleven years.”

Michael Spann of Antioch, Tennessee was stuck by a sudden, severe headache while coming down the stairs one day. “It felt like I got hit in teh head with a sledgehammer. I never felt anything like it,” he said. After that, his eyes, nose, and mouth began streaming with blood. He suffered from weekly haemolacria and constant headaches for seven years, and it made him very reclusive.

“I have kids that ride by on bikes in this neighborhood who piont and say, ‘That’s the guy who bleeds,'” he said. “I really don’t want more than that.”

His mother said, “He will start talking to someone, and his eyes will start filling up with blood. They haven’t seen it before, and it will scare the living daylights out of them. It is very frustrating not to be able to treat or even get some kind of remission for it.”

As you can imagine, it’s not easy getting a job with a condition like haemolacria. “Any job I get I lose because my eyes start bleeding and they can’t keep me on,” Spann said. “Obviously, I can’t be a waiter and work in any public thing because you are bleeding.”

The family attempted to get in touch with another haemolacriac (that isn’t actually the term as far as I know ~ I just made it up) boy by the name of Calvino Inman, a fifteen-year-old who also lived in Tennessee. Inman cried blood three times a day, often without warning, for periods that could last up to an hour.

“Sometimes I can feel it coming up, like a tear,” he said. “I feel my eyes watering. Sometimes it will burn as it comes out.”

He also has been affected by it. “I’ve been called possessed by almost all of my friends. I guess I’m used to it now. At first, it kind of hurt my feelings.”

As it should. Why would people be like that? I think haemolacria is awesome and fascinating ~ why else would I be writing a freaking essay about it? But I guess that’s just me.

Anyway.

Some cultures treat haemolacriac people with fear ~ as indicated by Inman’s friends. When I think about this I remember the olden days (REALLY olden days) when a girl with haemolacria would probably be accused of witchcraft and burned or tortured to death, which is sad to think about because it wouldn’t be her fault, but nothing she could say would change anyone’s mind. However, that is NOT the case with Rashida Khatoon from Putna, India, whose daily haemolacria caused her to be declared a holy miracle and is showered with gifts.

Haemolacria has also been shown slightly in film. “True Blood” has vampires who bleed from their eyes all the time, but those are vampires, so I don’t know, maybe that’s normal for them. The 2006 James Bond film, “Casino Royale,” sported immaculate-dressing supervillain Le Chiffre, who bled from his left eye. If I were to take a guess at the cause behind Le Chiffre’s singular haemolacria, I would guess that he’s got a torn tear duct in his left eye, because I haven’t heard of any cases where a person experienced bloody tears from only one eye. But that’s just my guess.

To add to the mystery, haemolacria seems to stop as suddenly and unexpectedly as it starts. “Most of these were relatively young patients,” Fleming said after he and Haik’s examinations. “As they matured, the bleeding decreased, subsided, and then stopped.”

I’m probably crazy for this, but I actually kind of want to experience haemolacria sometime. I just think it’s really cool, you know? (In my sick kind of appreciation.) The three-times-a-day thing doesn’t appeal to me too much. I can’t imagine how a person wouldn’t feel faint after losing all that blood. And I can’t really afford to be unemployed. But maybe if whenever I cried, it would be blood? That might be cool.

Yeah. I’m pretty sick.

SOURCES:

“Is It Possible to Cry Blood?” – health.howstuffworks.com/human-body/systems/eye/is-it-possible-to-cry-blood.htm

“A Rare Condition That Makes People Cry Blood” – http://mentalfloss.com/article/53423/haemolacria-rare-condition-makes-people-cry-blood

“Occult Haemolacria in Females” – http://www.ncbi.nlm.nih.gov/pubmed/1750328

“Bloody Tears of Unknown Cause: Case Series and Review of the Literature” – http://www.ncbi.nlm.nih.gov/pubmed/15599244

“Bloody Tears” – http://www.ijo.in/article.asp?issn=0301-4738;year=1987;volume=35;issue=1;spage=41;epage=43;aulast=Ahluwalia

“What is Haemolacria?” – http://www.wisegeekhealth.com/what-is-haemolacria.htm

“Throbbin’ Blood: A Beginner’s Guide to Haemolacria” – https://drmarkgriffiths.wordpress.com/2013/06/27/throbbin-blood-a-beginners-guide-to-haemolacria/#trackbacks

“Middle TN Man Who Cries Blood Searches For Answers” – http://www.tennessean.com/article/20131017/NEWS07/310170078/Middle-TN-man-who-cries-blood-searches-answers

“The US Teenager Who Cries Tears of Blood Three Times a Day” – http://www.dailymail.co.uk/news/article-1210647/U-S-teenager-cries-tears-blood-Calvino-Inman-hopes-doctors-explain-medical-mystery.html

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