Epiphora  (Updated 06/14/06)

You have a condition called epiphora, or excessive tearing.  Epiphora can be incited several different ways. 

These can be  broken down into three main categories: 

 1.  Insufficient drainage from the eye
  a.  Blocked Nasolacrimal duct / sac
  b.  Blocked punctum from redundant conjunctiva
  c.  Blocked canaliculus from stones
  d.  Narrow / misplaced drainage apparatus
  e.  Mechanical blockage of tear drain from eyelid masses or other means
  f.  Tear pump not functioning properly (eyelid abnormality)
  g.  Eyelild malposition causing tears to flow over the eyelid

 2.  Too much tear production 
  a.  Dry eyes
  b.  Allergy
  c.  Irritation from eyelid condition such as blepharitis or trichiasis (misdirected lashes)
  d.  Foreign body embedded in eye (cornea)
  e.  Various inflammatory conditions of eye such as iritis
  f.  Bell’s Palsy (aberrant regeneration of the 7th nerve – crocodile tears)

 3.  Any combination of the above

The first step in diagnosis and treatment is a thorough examination.  This assists us in determining the cause of your tearing, thereby suggesting the best approach to your condition.

Treatment for tearing is often a trial-and-error process.  If there is an obvious cause, we of course treat this first.  Often, however, there is no obvious cause, or there are multiple causes and we have to choose a direction for your treatment.  Then, working with your physician, you assist in eliminating possibilities in a systematic fashion.  The goal is to improve your symptoms.

Dry eyes can cause tearing (paradoxically) by stimulating the lacrimal gland (in the upper lid / orbit) to produce tears.  These tears are not the proper tears which stay in the eye and combat the dry eye.  These are “reflex” tears which are directed toward washing foreign material from the eye.  They evaporate quickly and do not “stick” to the eye like the tears which are made from the accessory lacrimal glands found in the eyelid and conjunctiva.

Your physician will help you make the decisions in treatment of your epiphora.  Please feel free to ask any questions you may have about the condition or any of the procedures involved.