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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 (including trichiasis and entropion) or an obstructed tear outflow tract, which is divided according to its anatomical location (i.e., ectropion, punctal, canalicular or nasolacrimal duct obstruction).
The resulting loose, excess conjunctiva may mechanically irritate the eye and disrupt the tear film and its outflow, leading to dry eye and excess tearing. [2] A correlation may also exist between inflammation in the eye and conjunctivochalasis, though it is unclear whether this correlation is causal.
A punctal plug, also known as tear duct plug or lacrimal plug, is a small medical device that is inserted into the tear duct (puncta) of an eye to block the duct. This prevents the drainage of liquid from the eye. They are used to treat dry eye. Artificial tears are usually still required after punctal plug insertion. [1]
When infected with AHC, patients will experience painful, red eyes, swelling of the conjunctival tissue, and frequent mucus discharge from the eyes accompanied by excessive tearing and subconjunctival hemorrhaging. This hemorrhaging is caused by the rupture of blood vessels beneath the conjunctiva giving the eyes a bright red appearance.
With the eye generally profusely watering, the type of tears being produced have little adhesive property. Water or saline eye drops tend therefore to be ineffective. Rather a 'better quality' of tear is required with higher 'wetting ability' (i.e. greater amount of glycoproteins) and so artificial tears (e.g. viscotears) are applied frequently.
Artificial tears are the recognized treatment of choice for this problem. [15] Artificial tears work by adding similar lubricating elements that natural tears contain. [17] This helps thicken and stabilize the pre-corneal tear film, prolonging tear film breakup time, and allowing for tears to properly protect the surface of the eyes. [17]
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Excessive tearing is the most common complaint of patients with nasolacrimal duct obstruction, followed by acute or chronic infections. [3] Pain at the side of the nose suggests dacryocystitis . Nasolacrimal duct obstruction is more common with increasing age and more common in females than males.