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What Is Hemolacria (Bloody Tears)?

Hemolacria is the presence of blood in tears, which can make tears look pink, red, or rust-colored. It can happen from bleeding anywhere along the tear pathway, from the eye surface to the tear duct and nasal passage. Some cases are mild and short-lived, while others point to an underlying condition that needs attention. Causes range from local irritation to infections, injuries, and growths in the tear system. Because the source is not always obvious, an eye exam is often needed to pinpoint where the bleeding starts.

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What Is Hemolacria (Bloody Tears)?

Hemolacria is the presence of blood in tears, which can make tears look pink, red, or rust-colored. It can happen from bleeding anywhere along the tear pathway, from the eye surface to the tear duct and nasal passage. Some cases are mild and short-lived, while others point to an underlying condition that needs attention. Causes range from local irritation to infections, injuries, and growths in the tear system. Because the source is not always obvious, an eye exam is often needed to pinpoint where the bleeding starts.

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What Can Cause Bloody Tears?

Bloody tears can start from the eyelids, conjunctiva, tear glands, or tear ducts, and the trigger is not always serious. Local inflammation, small surface injuries, and nose-related bleeding can also mix with tears and show up at the eye. Certain infections can irritate fragile vessels on the eye surface. Less commonly, tumors or vascular lesions in the tear drainage system can bleed. A clinician looks for both eye and nasal sources during evaluation.

How Do Doctors Check the Cause of Hemolacria?

A workup often includes a few practical steps to narrow down the source:

  • Checking the eyelids and eye surface for irritation, cuts, or inflamed tissue
  • Reviewing recent nosebleeds, sinus issues, or recent trauma
  • Examining the tear drainage openings and pressing near the tear sac
  • Looking for signs of infection, such as discharge, swelling, or tenderness
  • Ordering imaging or referral when a deeper tear-duct issue is suspected

When Should You Seek Care for Hemolacria?

You should get checked if bloody tears repeat, happen in large amounts, or come with pain or swelling. Sudden bleeding after an injury also needs medical review. In children, any repeated bloody tears should be evaluated without delay. If vision changes occur at the same time, that raises urgency. A prompt exam can rule out tear-duct problems and eye-surface disease.

What Should You Do If You Notice Bloody Tears More Than Once?

Bloody tears can come from the eyelid margin, the eye surface, or the tear drainage pathway, so the first step is getting the source checked. Pay attention to details like whether it happened after rubbing, contact lens wear, a recent nosebleed, or an eye infection. Pain, swelling near the inner corner, or any vision change should raise urgency. An eye exam can look at the surface under magnification and also evaluate the tear ducts if the bleeding seems to start deeper.

Frequently Asked Questions

Can a nosebleed cause bloody tears?

Yes, blood from the nose can travel backward through the tear drainage pathway in some cases. This can mix with tears and show up at the inner corner of the eye. An exam can help confirm whether the source is nasal rather than the eye.

Is hemolacria always serious?

No, some cases come from minor irritation or a small surface injury. Still, repeated episodes should be checked because tear-duct and eyelid problems can also cause bleeding. A clinician can rule out higher-risk causes.

Can contact lenses cause bloody tears?

They can if they trigger surface irritation or a small scratch on the conjunctiva or cornea. Overwear and poor hygiene can raise the risk of inflammation. If bloody tears happen with contacts, remove the lenses and get checked.

What tests might be done for hemolacria?

An eye doctor may do a slit-lamp exam to check the eye surface and eyelids. Tear-duct evaluation can include checking drainage and looking for swelling near the tear sac. Imaging is sometimes used when a deeper tear-path issue is suspected.

References

Bloody Tears. EyeWiki. https://eyewiki.org/Bloody_Tears. Date Accessed March 23, 2026.

Hemolacria. NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK539774/. Date Accessed March 23, 2026.

Blood-stained tears are a rare symptom of lacrimal drainage apparatus malignancies. American Academy of Ophthalmology. https://www.aao.org/education/editors-choice/blood-stained-tears-are-rare-symptom-of-lacrimal-d. Date Accessed March 23, 2026.

Haemolacria: A Unique Diagnostic And Treatment Approach. Investigative Ophthalmology & Visual Science. https://iovs.arvojournals.org/article.aspx?articleid=2350852. Date Accessed March 23, 2026.

A healthy young girl crying out blood: A case report. PubMed Central. https://pmc.ncbi.nlm.nih.gov/articles/PMC8453654/. Date Accessed March 23, 2026.