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K. Mukkamala, L. Rao, R. C. Gentile, V. Doshi; Hemolacria: A Sign of Scleral Buckle Infection. Invest. Ophthalmol. Vis. Sci. 2009;50(13):6055.
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To report hemolacria or bloody tears as a sign of scleral buckle infection with occult exposure.
The records of three eyes of three patients with hemolacria after scleral buckle placement were reviewed.
A 70 year-old man, a 22 year-old woman, and a 59 year-old man were referred for hemolacria following scleral buckle placement. All patients underwent an encircling silicone sponge for primary rhegmatogenous retinal detachment by two other surgeons. The first two patients had chronic recurrent hemolacria for over two years prior to diagnosis and the latter patient presented with acute hemolacria ten weeks after buckling surgery. An occult conjunctival fistula continuous with an exposed scleral buckle was identified and swab cultures grew Staphylococcus aureus in all eyes. Hemolacria resolved with explantation of the scleral buckle in two patients and with long term continuous topical antibiotics in the other.
Hemolacria or bloody tears is a sign of scleral buckle infection and should raise a high level of clinical suspicion of exposure with occult fistula when frank exposure is not seen.
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