Tearing Eye (Epiphora)

Tearing Eye (Epiphora) Causes The main causes of i is constriction or obstruction of tear drainage system from the eyes. It may happen as a congenital or acquired condition, especially in women. Other causes include trauma to eye and face, some medications and sinus diseases. Among other reasons for epiphora eyelid malpositions and irritating agents should be considered. Clinical symptoms The main complaint of patients is excessive tearing. Sometimes blurring of vision secondary to accumulation of tear over the eye happen. Eyelids may become sticky and purulent eye discharge occur. Sometime an acute infection superimposes and present with pain, swelling and redness in the medial part of the eye beside the nose. Treatment In infants treatment includes correct massage of lacrimal sac and topical antibiotic drops. In 90% of infants the obstructed lacrimal duct will open spontaneously. In unresolved cases lacrimal probing may be considered especially after 12 months of age. In adults with lacrimal drainage obstruction probing has no role in treatment, rather they usually need surgery, usually named dacryocystorrhinostomy (DCR) to relieve the obstruction. DCR could be performed from external (via skin incision- external DCR) or via nasal cavity (endonasal endoscopic DCR) or recently via eyelid lacrimal ducts (trans-canalicualr endocopic DCR). Although, the advantage of the endoscopic procedures is lack of visible skin scar, but external DCR has remained the gold standard technique because of higher success rate. The expert lacrimal surgeon is the best who can offer the best approach to the patient considering different aspects of the disease and patients demands. Precautions Patients should hold all medications that can increase the chance of pre- and post-operative bleeding, such as aspirin, ibuprofen, warfarin, 2 weeks before surgery.