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ABSTRACT
Vicarious menstruation represents cyclical bleeding in extragenital organs during a normal menstrual cycle. We present an unusual case of ocular vicarious menstruation (bloody tears) in a 17-year-old girl. The indications and treatment of this rare disorder are discussed.
INTRODUCTION
Vicarious menstruation is a rare condition manifested by cyclical bleeding in extragenital organs during menstruation. The bleeding may precede or coincide with normal menstruation, or it may occur cyclically in amenorrheic women. Although the nasal mucosa ia the moat common site of extragenital bleeding, other sites such as the lung, stomach, intestine, kidney, lips, skull, skin, and eyes have been reported as well.1 Two forms of vicarious menstruation have been described: supplementary, in which bleeding occurs regularly in the absence of menstruation, and substitutive, in which extrauterine bleeding is concomitant with the menstrual cycle- The latter form represents 30% of all cases of vicarious menstruation.1·3 We present an unusual case of ocular vicarious menstruation in a 17-yearold girl.
CASE REPORT
A 17-year-old girl presented with intermittent bleeding from the right eye during her menstrual cycle for the first time in March 1984. Up to that time her menstrual cycles, which started at the age of 13, were uneventful, The eye bleeding episodes lasted for two to three minutes, increased in frequency up to ten episodes per day, and were preceded by retro-orbital pain and pressure in the right eye. Those symptoms were entirely relieved once the bleeding started. She denied diplopia, decrease in vision, photophobia, loss of smell, numbness of her cheeks, sinus pain, temporomandibular joint pain, epistaxis, or bleeding disorders. She complained ol" intermittent right sided headaches that were controlled with Tylenol "] with codeine....