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Case Reports
. 2023 Jan 30:13:Doc05.
doi: 10.3205/oc000213. eCollection 2023.

A rare cause of recurrent subconjunctival hemorrhage: ocular vicarious menstruation

Ali Riza Cenk Celebi  1 , Elif Ganime Aygun  2
Affiliations
Case Reports

A rare cause of recurrent subconjunctival hemorrhage: ocular vicarious menstruation

Ali Riza Cenk Celebi et al. GMS Ophthalmol Cases. .

Abstract

Purpose: Vicarious menstruation is cyclical bleeding in extra-uterine locations that occurs during menstruation or within 48 h of its onset. We aim to present a 43-year-old female with ocular vicarious menstruation, its treatment, and a review of other published cases of ocular vicarious menstruation.

Case description: A 43-year-old Caucasian female presented with a 15-year history of recurrent monthly unilateral subconjunctival hemorrhage. The episodes were cyclical and coincided with the onset of menses, lasting for approximately 10 to 14 days. Slit-lamp examination of the right eye showed nasally located subconjunctival hemorrhage. Detailed laboratory findings, including parameters for various hematological disorders, were normal. A follow-up examination 2 weeks later showed that the subconjunctival hemorrhage in the right eye was completely resolved. The patient was prescribed the oral contraceptive levonorgestrel/ethinyl estradiol and marked improvement at the recurrences of subconjunctival hemorrhage was noted during subsequent menses.

Conclusion: Ocular vicarious menstruation is among the rarest causes of recurrent subconjunctival hemorrhage. A therapeutic trial of oral contraceptive should be considered in patients that present with ocular vicarious menstruation.

Keywords: extrauterine bleeding; ocular vicarious menstruation; oral contraceptive pills; recurrent subconjunctival hemorrhage.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1. Slit-lamp image of the patient’s right eye at the onset of menstruation shows nasally located subconjunctival hemorrhage.
Figure 2
Figure 2. Slit-lamp image of the patient’s right eye 1 week after the onset of menstruation shows that the subconjunctival hemorrhage is beginning to clear.
Figure 3
Figure 3. Slit-lamp image of the patient’s right eye 2 weeks after the onset of menstruation shows total resolution of subconjunctival hemorrhage.
See this image and copyright information in PMC

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