| Epiphora (medicine) | |
|---|---|
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| Specialty | Ophthalmology |
Epiphora is an overflow of tears onto the face, other than caused by normalcrying. It is aclinical sign or condition that constitutes insufficienttear film drainage from theeyes, in that tears will drain down the face rather than through the nasolacrimal system.[1]
Causes of epiphora are any that cause either overproduction of tears or decreased drainage of tears, resulting in tearing onto the cheek.[2] This can be due to ocular irritation and inflammation (includingtrichiasis andentropion) or anobstructed tear outflow tract, which is divided according to its anatomical location (i.e., ectropion, punctal, canalicular or nasolacrimal duct obstruction). The latter is often due to aging (a spontaneous process),conjunctivochalasis, infection (i.e.dacryocystitis),rhinitis, and in neonates or infants, failure of the nasolacrimal duct to open.[citation needed]
Another cause could be poor reconstruction of the nasolacrimal duct system after trauma to the area. Cause of trauma could be facial fractures (including nasoethmoid fractures or maxillaryLe Fort fractures), and soft-tissue trauma involving the nose and/or the eyelid. This condition is often frustrating or irritating.[citation needed]
A systematic review studying the usage ofpunctal plugs for treatment ofdry eye reported a few cases of epiphora among participants.[3]
Diagnosis of epiphora is clinical by history presentation and observation of the lids.[citation needed]
Fluorescein dye can be used to examine for punctal reflux by pressing on the canaliculi in which the clinician should note resistance of reflux as it irrigates through the punctum into the nose.Dacryoscintigraphy is an imaging method used to detect obstructions in thelacrimal apparatus.[citation needed]
If epiphora is caused by ectropion or entropion, lid repair is indicated. Punctal irrigation is also required. In infants with nasolacrimal defects, a nasolacrimal duct probe is used and a tube replacement, either temporary (Crawford) or permanent (Jones), is carried out. A surgical procedure called adacryocystorhinostomy is done to join the lacrimal sac to the nasal mucosa in order to restore lacrimal drainage.[citation needed]