Abstract

Objective: To present a rare case of catamenial bilateral conjunctival hemorrhage associated with endometriosis in a patient with ovarian endometrioma and to discuss its possible hormonal pathogenesis.

Case: A 24-year-old nulliparous woman presented with a 10-year history of severe dysmenorrhea and recurrent bilateral subconjunctival hemorrhage occurring exclusively during menstruation. Ophthalmologic examinations revealed no additional pathology. Pelvic ultrasonography demonstrated a 70×55-mm homogeneous cystic lesion with low-level internal echoes in the right ovary, consistent with an endometrioma. Serum CA-125 was mildly elevated (48.5 U/mL). Orbital magnetic resonance imaging was normal. Combined oral contraceptive therapy containing drospirenone and ethinylestradiol was initiated, resulting in marked improvement in both dysmenorrhea and ocular hemorrhage.

Conclusion: Catamenial conjunctival hemorrhage is a rare but clinically relevant manifestation that may be hormonally mediated. In patients presenting with cyclic ocular bleeding, underlying endometriosis should be considered.

Keywords: endometriosis, endometrioma, conjunctival hemorrhage, menstruation, dysmenorrhea

Copyright and license

Copyright © 2026 The Author(s). This is an open-access article published by Bolu İzzet Baysal Training and Research Hospital under the terms of the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Esmer EB. Catamenial bilateral conjunctival hemorrhage associated with endometriosis: A rare case report. Northwestern Med J. 2026;6(4):364-7. https://doi.org/10.54307/NWMJ.2026.257

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