title: Haemolacria: A Novel Approach to Lesion Localization.
abstract: OBJECTIVE
  To report the use of punctal plugs as a new modality to assist in the localization of lesions providing symptomatic relief in patients with haemolacria during their workup.
  
  
  METHODS
  Retrospective case series.
  
  
  RESULTS
  One boy and one girl, ages 16 and 20, respectively, reported spontaneous bloody tearing. Workup included probing and irrigation of the nasolacrimal system, blood and coagulation profiles, blood typing, serum hormone levels, conjunctival biopsy, and imaging. All findings were normal and failed to suggest a cause in any of the cases. Punctal plugs were inserted into each patient's inferior punctum OS without complication. On initial follow-up visits, each patient reported cessation of bloody tears OS with continued bloody tears OD. Over time, both patients experienced complete cessation of haemolacria in both eyes.
  
  
  CONCLUSIONS
  Haemolacria is a condition caused by a group of disorders that result in the production of tears that are partially composed of blood. The large majority of cases result in a specific diagnosis. Only rarely does workup result in undetermined etiology. The novel approach of utilizing punctal plugs in the management of haemolacria may not only provide symptomatic relief for lesions distal to and including the punctum, but also assists in anatomic localization in idiopathic cases.
authors.affiliation: a Hamilton Eye Institute University of Tennessee Health Science Center , Memphis , Tennessee , USA and.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Fowler
authors.affiliation: a Hamilton Eye Institute University of Tennessee Health Science Center , Memphis , Tennessee , USA and.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Kosko
authors.affiliation: a Hamilton Eye Institute University of Tennessee Health Science Center , Memphis , Tennessee , USA and.
authors.forename: Trey A
authors.initials: TA
authors.lastname: Pegram
authors.affiliation: a Hamilton Eye Institute University of Tennessee Health Science Center , Memphis , Tennessee , USA and.
authors.forename: Barrett G
authors.initials: BG
authors.lastname: Haik
authors.affiliation: a Hamilton Eye Institute University of Tennessee Health Science Center , Memphis , Tennessee , USA and.
authors.forename: James C
authors.initials: JC
authors.lastname: Fleming
authors.affiliation: b Gailey Eye Clinic , Bloomington , Illinois , USA.
authors.forename: Alan E
authors.initials: AE
authors.lastname: Oester
mesh_terms: D000293:Adolescent; D001769:Blood; D003941:Diagnostic Techniques, Ophthalmological; D005130:Eye Hemorrhage / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D009301:Nasolacrimal Duct / Q000473:pathology; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012008:Recurrence; D012189:Retrospective Studies; D013666:Tears; D055815:Young Adult
keywords: Bloody; haemolacria; idiopathic; localization; plugs; punctal; tear