Epiphora

Epiphora (watery eye) has several causes, and management depends on the patient’s age and associated history. Epiphora may be associated with obstructed drainage or with increased lacrimation, often associated with dry eye disease. Lacrimal punctal stenosis and nasolacrimal duct obstruction (see Diagram of the eye) are common causes.

In children under 2 years, congenital nasolacrimal duct obstruction usually responds to removal of mucoid discharge and massaging of the lacrimal sac. If the obstruction does not resolve by 12 to 18 months of age, probing under general anaesthesia may be required.

In adults, punctal stenosis or nasolacrimal duct obstruction may require surgical management.

Do not use antibiotic therapy for epiphora; consider antibiotic therapy if the patient has signs of bacterial conjunctivitis or dacryocystitis.