Bloody tears: A new option for early diagnosis of endometriosis

Aims/Purpose: To investigate the cytological composition of tears to determine the potential diagnostic criteria of endometriosis. Methods: Tear samples obtained from the lower fornix of the conjunctiva using a glass capillary tube were examined by microscopy in 100 people: 60 healthy women who made up the control group and 40 patients with endometriosis. Results: The proportion of women with endometriosis, in whose tear erythrocytes were determined was significantly higher, 32.5%, compared with the control group ‐ 25.0%. In 69.2% of women with endometriosis, latent haemolacria was detected in the follicular phase of the menstrual cycle, which significantly exceeded the 30.8% of people with erythrocytes in tears detected in the luteal phase. Epitheliocytes were found in tears in 97.5% of patients with endometriosis versus 75.0% of healthy women, at the same time, in 100.0% cases, − in the follicular phase of the menstrual cycle, compared with 74.3% of healthy women in the same phase of the cycle. The proportion of women with epitheliocytes in the tear in the amount of “++” was 56.4%, which was significantly more compared to 20.0% of people from the control group with epitheliocytes in the same amount; at the same time, group accumulations of epitheliocytes were found in 15.0% of patients with endometriosis, which was significantly higher than in healthy women ‐ 8.3%. In 90.0% of cases in the group with endometriosis, glandular cuboidal epithelial cells were found in the tear, morphologically resembling endometrial cells. Conclusions: The revealed features of the cytological composition of tears in patients with endometriosis, which differed from those in the control group, reflected certain links in its etiopathogenesis, so the study of tear parameters can be useful for predicting the prevalence of “endometrioid disease” and developing pathogenetically substantiated treatment.