Summary:
Bloody tears (Haemolacria) are a rare symptom that can be
caused by local or systemic pathology. It is one of the most
alarming symptom in ophthalmology. Besides those,
idiopathic cases have been reported. A case of hyperthyroidism
where haemolacria was secondary to the condition has also
been reported. Haemolacria are also reported as secondary to
epistaxis. Psychogenic causes are described including
Munchausen Syndrome by proxy. Here we describe a series
of four cases of haemolacria along with bleeding from other
sites, found as associated features of dissociative disorders.
In this series, patients with age ranging from 14-17 years,
three of them are female and one male have been included.
Examination excluded local ocular and nasal pathology,
coagulopathy and hyperthyroidism. In course of their illness,
two of these cases met the DSM 5 criteria for both dissociative
disorders and conversion disorders, rest of them have been
diagnosed as mixed dissociative disorders. After appropriate
intervention, three patients recovered completely and in one
patient symptoms (also bleeding) recurred on re-exposure to
the previous stress factors.
We report three cases of Dissociative disorders and one with
both dissociative and conversion disorder where bloody tears
were one of the feature. To the best of our knowledge this is
the first official report of its kind in Bangladesh.
(J Bangladesh Coll Phys Surg 2017; 35: 36-42)