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Dr. Tom
Dr. Tom, Board Certified MD
Category: Eye
Satisfied Customers: 264
Experience:  30 years experience treating patients with eye problems
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I have a clogged tear duct and as a result my eye tears a

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I have a clogged tear duct and as a result my eye tears a lot. However, this evening, my tears have been pronouncedly spotted with blood. What may account fpr this development? What measures are advised with such a symptom?
Dr. Tom : Hi, I'm online now and would be happy to help you with your question.I understand what you are asking. Just reply and we'll get started. Dr. Tom
JACUSTOMER-mg6p7jj1- : I'm ready to engage you in an online chat about this condition
JACUSTOMER-mg6p7jj1- : Are you still there?
Dr. Tom :

Yes we we seem to be connected. Let me ask a couple of additional questions

JACUSTOMER-mg6p7jj1- : Please proceed
Dr. Tom :

Would you please tell me about previous examinations you have had to determine where the clogged tear duct is actually located. Have you had an ophthalmologist examine you for the same problem. And how many times in the last month or two have you seen the blood?

JACUSTOMER-mg6p7jj1- : I have had this problem examined over the years and have had two procedures that tried to clear the tear duct. Most recently, the procedure to direct the flow through my nasal cavity has been performed in February 2012. Since then, on occasion I've noticed traces of blood in my tears after wiping my eye. This time the bleeding is quite obvious is seems to be continuous. That is a new phenomenon
Dr. Tom :

Thank you for that additional information The two essential questions are where in the nasal lacrimal duct system is the blockage and what is the source of the blood you are finding. A thorough examination of the nasal lacrimal duct helps the ophthalmologist determine where the blockage is located. In an adult it is most typically in the nasal lacrimal sac. Since you have already had a surgical procedure, probably a DCR, any new blockage is probably related to the area where the surgery was performed. If you put pressure deep in the corner of your eye nearest your nose do you feel any swelling or pain?

Dr. Tom :

As you say that you have noticed traces of blood in your tears previously but this time it seems to be continuous, there is the possibility that a small blood vessel just inside the lacrimal channel is ousing a small amount of blood which is leaking into your tear film. Have you noticed any blood in your nose if you give it a good blow?

JACUSTOMER-mg6p7jj1- : IT was indeed the lacrimal sac that was supposed to be perforated to channel the tears through the nose, In my opinion, the procedure has not succeeded it clearing the blockage.
JACUSTOMER-mg6p7jj1- : When I press in the corner of my eye nearest the nose, all that I obtain are spots of blood. There has been no sign of blood when I blow my nose
Dr. Tom :

Yes it sounds that way to me as well. However, I would say that DCRs are generally quite successful. Do you have the opportunity to return to the ophthalmic surgeon did your procedure. It may be something as simple as a temporary re-placement of a little silicone tube to ensure that the channel is open.

JACUSTOMER-mg6p7jj1- : I won't be able to do that until next Monday, if she is available to see me then. And it was DCR. I recall that abbreviation.
Dr. Tom :

Yes I understand, however I think that is acceptable. The obvious warning would be relative to extensive bleeding which would be presenting in your nose and throat. Since you're not experiencing that, it doesn't sound like you need to do anything on an emergency basis. Does that generally makes sense to you, and do you have any other questions?

JACUSTOMER-mg6p7jj1- : My concern is the continuous presence of blood in my tears. It's a rather scary sensation. Can I wait until next week? I am currently out of the U.S. Should something be done locally at some point? What should I be on the look out for in order to seek some immediate medical assistance.
Dr. Tom :

It seems that we typed over each other. Did you get the answer you wanted from the previous paragraph I typed before your last concern popped up?

Dr. Tom :

The need to seekt some immediate medical assistance should be determined based on the degree of bleeding that you are experiencing. If you are beginning to notice a nosebleed or blood on the back of your throat it would be prudent to have a local emergency room checking. If the spotting you mentioned is limited to your tear film you should be okay to wait until you can get home. Does that seem like a reasonable approach to you?

JACUSTOMER-mg6p7jj1- : Not quite. I do want to know what new symptoms in this bleeding would call for immediate medical attention? Currently the tears with the blood don't seem to be flowing through to the nose. But that hasn't been happening for quite a while since the DCR? Is it reasonable to tolerate this blood for 5 days?
Dr. Tom :

"new symptoms in this bleeding which would call for immediate medical attention" would include nosebleeds, significant swelling in the area of the lachrymose site

Dr. Tom :

Sorry, in the lacrimal sac or the development of an elevated temperature which might suggest an infection.

JACUSTOMER-mg6p7jj1- : Got it. Thank you.
Dr. Tom :

Based on having followed many patients post DCR, we do see a few who need a revision of the surgical procedure. We won't know if that would be required for you until you are checked out, but I really don't think you're going to get in any trouble between now and when you can see your ophthalmologist based on only having the blood in the tears.

Dr. Tom :

Please let me know if you have any other questions. I know it's scary when something unexpected occurs when we're out of the country, but I expect you'll be just fine.

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Customer: replied 4 years ago.
Thank you for your online diagnosis. Condition has improved. Pressence of blood in tears has significantly diminished and none was detected in my throat or nose. I have scheduled an appointment with my opthomologist for Monday morning in order to get to the bottom of this problem.
Again thank you. Your advice was most reassuring and most accurate as to the potential directions that this condition might take. Most importantly, I am able to enjoy the rest of my vacation.
Thanks for the update......and best wishes. Tom