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Involutional stenosis is probably the most common cause of nasolacrimal duct obstruction in older people. It affects women twice as frequently as men. Although the inciting event in this process is unknown, clinicopathologic study suggests that compression of the lumen of the nasolacrimal duct is caused by inflammatory infiltrates and edema.
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]
Obstruction of the nasolacrimal duct may occur. [4] [5] [6] This leads to the excess overflow of tears called epiphora (chronic low-grade nasolacrimal duct occlusion). [7] A congenital obstruction can cause cystic expansion of the duct and is called a dacryocystocele or Timo cyst.
Dacryocystitis is an infection of the lacrimal sac, secondary to obstruction of the nasolacrimal duct at the junction of the lacrimal sac. [1] The term derives from Greek dákryon 'tear' cysta 'sac' and -itis 'inflammation'. [2] It causes pain, redness, and swelling over the inner aspect of the lower eyelid and epiphora.
The lacrimal gland is a compound tubuloacinar gland, it is made up of many lobules separated by connective tissue, each lobule contains many acini.The acini composed of large serous cells which, produce a watery serous secretion, serous cells are filled with lightly stained secretory granules and surrounded by well-developed myoepithelial cells and a sparse, vascular stroma.
If the cause of dacryoadenitis is a viral condition such as mumps, simple rest and warm compresses may be all that is needed. For other causes, the treatment is specific to the causative disease. For other causes, the treatment is specific to the causative disease.
Other causes include congenital alacrima, xerophthalmia, lacrimal gland ablation, and sensory denervation. [14] In rare cases, it may be a symptom of collagen vascular diseases, including relapsing polychondritis, rheumatoid arthritis, granulomatosis with polyangiitis, and systemic lupus erythematosus.