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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