Epiphora (Watery Eye)

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 Definition

It is watering from an eye due to decreased drainage of tears.

 

Causes of  Epiphora

Obstructive Epiphora: Decreased drainage is due to mechanical obstruction at the level of the punctum, the canaliculi, the sac, or the nasolacrimal duct. The causes include;

  • Punctal stenosis
  • Canalicular atresia
  • Infection dacryocystitis
  • Chronic sinus disease 
  • Growth in the lacrimal sac
Lacrimal pump failure: Decreased drainage is due to the inability of the pumping mechanism to drain tear, despite the patent drainage system.
It is caused by:
  • Lower lid laxity
  • Facial palsy
  • Lower lid ectropion
Diagnosis of Epiphora
  1. Clinical examination 
  • Eyelid position
  • Orbiularis oculi muscles function
  • Regurgitation test
  • Nasal examination is important to exclude deviation of spetum or growth e.g. nasal polyp.
Lacrimal system patency test
  1. Dye disappearance test
  2. Diagnostic test
  3. Jones dye test ( Primary & Secondary Jones dye test)
  4. Dacryocystography
  5. Lacrimal scintillaography
Treatment of Epiphora
  • The lacrimal pump failure is treated by restoring the position of the eyelid and punctum.
  • The obstruction to the drainage system is treated surgically and the type of surgery depend upon the level of obstruction.

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