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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).
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]
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. [3]
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Punctal plugs are thought to be "relatively safe", however, their use may result in epiphora (watery eyes), and more rarely, serious infection and swelling of the tear sac where the tears drain. [60] They are reserved for people with moderate or severe dry eye when other medical treatment has not been adequate. [4]
Watery eyes – due to excessive tearing. [7] Red eyes – due to dilated blood vessels on the sclera. [7] Swollen eyelids – due to inflammation. [7] Crusting at the eyelid margins/base of the eyelashes/medial canthus, generally worse on waking – due to excessive bacterial buildup along the lid margins. [4] [5] [7]
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.
Persons with dry eye conditions can be fitted with punctal plugs that seal the ducts to limit the amount of fluid drainage and retain moisture. During an ear infection, excess mucus may drain through the nasolacrimal duct in the opposite way tears drain. [citation needed] In humans, the tear ducts in males tend to be larger than the ones in ...