Background Hemolacria is a rare condition that is characterized by the presence of blood in tears. It is a rare condition due to which insufficient literature and resources are present. Therefore, its prevalence and predilection for a specific gender, race or age remain uncertain. Hemolacria is one of the most alarming symptoms in ophthalmology, associated with multiple underlying etiologies and diseases. Case report We report an unusual case of a 12-year-old female patient who experienced episodic bilateral bloody tears for 3 days, which was associated with epistaxis. The patient's condition was thoroughly evaluated, and all investigations were unremarkable. The patient was then referred to an ophthalmologist for evaluation, and a slit-lamp examination was also unremarkable. After performing all necessary investigations and taking various causes of hemolacria into account, the child was diagnosed as having idiopathic hemolacria. The patient and parent were appropriately counseled regarding the disease, and thereafter, the patient is being followed-up by an ophthalmologist. The reports of the follow-up performed after a month from presentation stated that the patient was progressing favorably, and the bloody tears were resolved spontaneously.

Introduction: We report an eight-case series of coronavirus disease 2019 (COVID-19)-related multisystem inflammatory syndrome in children (MIS-C). Methods: Children who tested positive for COVID-19, met the MIS-C criteria of the World Health Organization (WHO), and were hospitalized at a tertiary hospital in Riyadh from September to December 2021 were identified and their clinical data reviewed. Results: The age at diagnosis is between 4 to 13 years old. Fever, decreased oral intake, gastroenteritis, and abdominal pain were the most common symptoms. All cases showed hyperinflammation with high C-reactive protein, erythrocyte sedimentation rate, ferritin levels, and deranged coagulation profiles. Most of the cases had elevated B-type natriuretic peptide (75%) and troponin (100%) levels. However, two cases had cardiovascular involvement. Two patients presented with acute respiratory distress syndrome and required mechanical ventilation. The mean hospital stay was 13.1 days, with seven patients initially requiring intensive care management for ionotropic support. Most cases required broad-spectrum antibiotics, intravenous steroids, intravenous immunoglobulin, and aspirin. All patients recovered and were discharged from the hospital in good clinical condition. Conclusion: Children with COVID-19 are at risk of developing MIS-C. Practitioners must have a high index of suspicion for its diagnosis and should start treatment as soon as possible to prevent unfavorable outcomes.