Why do some people cry tears of blood? (2023)

Can you imagine crying bloody tears? It might sound like a horror movie, but the bloody tears are actually real. Blood in tears is a rare condition known as hemolacria. Tears of blood have been documented over the centuries, often with negative connotations.

In some cultures, tears of blood were once believed to be associated with demonic possession. Fortunately, most cases of hemolacria are benign and usually present with a reasonable explanation. However, several conditions must be considered when diagnosing it.

Before we examine the possible causes, let's review the anatomy of the nasolacrimal system, which is responsible for producing and removing tears.

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Why do some people cry tears of blood? (1)

tear production

The tear-producing nasolacrimal system consists of several parts. The lacrimal gland is a large gland thatsecretes tears. It is located under the eyelid of the eye socket. Its function is to bring tears to the surface of the eye.

Normal, everyday tears are called basal tears. Tears produced by emotions or when something is in the eye are called reflex tears. There are also small glands in the eyelid that produce tears.

Meibomian drusencoats the eyelid to secrete oil that helps stabilize the tear film and prevent evaporation. The lacrimal system is mainly controlled by the parasympathetic nervous system and partly by the sympathetic nervous system.

Each eyelid usually has a tear point located along its rim in the area of ​​its nasal area. These dots are small holes that are easily seen on the surface of the eyelid rim. Each point has a small tube or canaliculus that leads to the nasolacrimal sac.

The nasolacrimal sac then becomes the nasolacrimal duct and opens into the inferior duct (small opening) of the nose. There is usually a small valve that allows tears to flow into the nose, but not tears to flow up through the ducts.

The tears themselves lubricate the eye and help the eye produce an optically clear image. Tears also carry nutrients, electrolytes, natural antibiotics, and oxygen to the surface of the eye and the cornea, the transparent, dome-shaped structure at the front of the eye.


Most tears that contain blood are caused by the following conditions:

  • conjunctival lesion: The conjunctiva is a transparent membrane of tissue that sits on top of the sclera, the white part of the eye. Within the conjunctiva is a network of blood vessels. Sometimes infection, inflammation or lacerations can occurcause bleeding from the conjunctiva, as it is so rich in blood vessels.The blood just oozes out and mixes with the tears, giving the impression that the person is producing bloody tears.
  • blood diseases:blood diseases, including hemophilia, can cause excessive bleeding due to clotting problems. People with hemophilia can bruise or bleed easily. This can appear as tears of blood in the eyes. Other medical conditions that require taking blood thinners can also cause people to have bloody tears. Drugs like aspirin or heparin can be to blame in these cases. Patients who bruise or bleed frequently should be evaluated by their GP or internist.
  • pyogenes Granulom: A pyogenic granuloma is a highly vascularized benign tumor that can grow in the conjunctiva or the lacrimal sac.The lacrimal sac is the common junction where the two tear drainage ducts unite to drain tears. A pyogenic granuloma can result from an injury, an insect bite, or acute inflammation. Pyogenic granulomas are also common during pregnancy due to hormonal changes in the body.
  • nosebleeds: bleeding in the nasal cavity (nosebleeds) is technically called epistaxis.As described above, the lacrimal system, which produces and drains human tears, is connected to the nasal cavity. When we blink, our eyelids exert a slight diagonal pressure towards the corner of the eye where the dots are located. The puncta are small holes through which tears drain. The stitches enter the lacrimal sac and then the tear duct and nose. This system describes the reason why your nose gets blocked when you cry. Blowing or pinching your nose when you have a nosebleed can push blood back up through the nasolacrimal system. This causes blood to rush back through the puncta into the tears, making the tears appear to be made of blood.
  • Malignant neoplasm of the lacrimal sac:Malignant melanoma can occur anywhere in the body, including the lacrimal sac, the lacrimal gland, and the conjunctiva.People with melanoma in these areas may have bloody tears. Other malignancies of the lacrimal sac, lacrimal gland, or conjunctiva can also cause bloody tears. These are very serious conditions that require immediate treatment.
  • Uncontrolled high blood pressure:Although rare, bloody tears have been documented in untreated hypertension. In most cases, it is a ruptured blood vessel in the conjunctiva or nasal tissue. Because blood pressure is high, excessive bleeding can occur. However, once the high blood pressure is lowered with medication, the tearing of the blood stops.
  • Hormonal causes:Studies have documented hemolacria during menstruation. Most likely, the bleeding is caused by hormonal changes. Blood in tears is usually found in smaller quantities and does not cause significant discomfort to the affected woman.
  • Idiopathic Cause:There have been several instances where someone cried bloody tears with no explanation and no medical cause. No serious disease or disorder has been identified in these cases, and the condition appears to be improving over time. No scientific explanation has been found for this rare phenomenon.

A word from Verywell

Blood in tears, known medically as a bruise, is a rare condition. Although it's usually benign, if you notice blood mixing with your tears, you should see an eye doctor for an evaluation. Most cases of bloody tears usually subside as quickly as they begin, but in some cases, serious causes such as uncontrolled high blood pressure, malignant melanoma, or injury are to blame.

Frequently Asked Questions

  • Can you cry blood?

    Something like. The phenomenon of "crying blood" actually consists of regular tears soaked with blood. This is a rare condition known as hemolacria.

  • What does the lacrimal gland secrete?

    The lacrimal gland secretes tears on the surface of the eye. It is part of the nasolacrimal system that keeps the eyes lubricated and healthy.

6 gears

Verywell Health uses only quality sources, including peer-reviewed studies, to back up the facts in our articles. read ourspublishing processto learn more about how we review our content and keep it accurate, reliable, and trustworthy.

  1. Qin B., Chen S.conjunctival lesion.Atlas of Eye Trauma. 2019; 9-12. Springer, Singapore. doi:10.1007/978-981-13-1450-6_2

  2. Wollina U., Langner D., França K., Gianfaldoni S., Lotti T., Tchernev G.Pyogenic granuloma: a common benign vascular tumor with variable clinical presentation: new insights and treatment options.Open Access Maced J Med Sci. 2017;5(4):423–426. doi:10.3889/oamjms.2017.111

  3. Cleveland Clinic.nosebleeds (epistaxis).

  4. El-Sawy T, Frank SJ, Hanna E, et al.Multidisciplinary management of lacrimal sac/nasal duct carcinoma.Plastic reconstruction surgery on the eye. 2013;29(6):454–457. doi:10.1097/IOP.0b013e31829f3a73

  5. Dillivan KM.Hemolacria in a patient with severe systemic diseases.i want you to know. 2013;90(6):e161-6. doi:10.1097/OPX.0b013e318294c172

  6. Beyazyıldız E, Özdamar Y, Beyazyıldız Ö, Yerli H.Idiopathic bilateral bloody tearing.Ophthalmol With Fallvertret. 2015;2015:692382. doi:10.1155/2015/692382

Why do some people cry tears of blood? (2)

VonTroy Bedinghaus, OD
Troy L. Bedinghaus, OD, a board certified optometrist, is the owner of Lakewood Family Eye Care in Florida. He is an active member of the American Optometric Association.

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