Catamenial Bilateral Conjunctival Hemorrhage Associated with Endometrioma: A Rare Case Report

INTRODUCTIONEndometriosis is a chronic, estrogen-dependent disease characterized by the presence of endometrial glands and stroma outside the uterine cavity, affecting approximately 10% of women of reproductive age (1). Although the disease most commonly involves pelvic organs, extragenital involvement has also been reported, albeit rarely (2). Ovarian endometrioma is one of the most common forms of endometriosis and is closely associated with dysmenorrhea, chronic pelvic pain, and infertility (2).Menstruation-related ocular manifestations are extremely rare and have been described in the literature under the terms “ocular vicarious menstruation” or “catamenial conjunctival hemorrhage” (3). In these cases, conjunctival hyperemia or subconjunctival hemorrhage synchronized with the menstrual cycle is the predominant finding, while ophthalmologic evaluations usually reveal no additional pathology (3). Although the exact pathophysiology remains unclear, hormonally mediated increases in vascular permeability have been proposed as potential mechanisms (5).In this report, we present a young patient with long-standing dysmenorrhea and recurrent bilateral conjunctival hemorrhage occurring during menstruation, in whom a concomitant ovarian endometrioma was identified, and discuss the case in light of the current literature.