Tears and the lacrimal apparatus
In the eye, there is a constant process of tears’ production and drainage. Tears are crucial for lubricating the external surface of the eye and covering the ocular surface due to blinking. The lack of tears or their excessive production is in position to affect patient’s daily activities and affect vision.
The lacrimal apparatus consists of a number of anatomical elements (lacrimal glands, lacrimal points, lacrimal ducts, lacrimal sac, nasolacrimal duct) that contribute to smooth production and drainage of the tears. The proper functionality of the lacrimal apparatus is fundamental, as there are various pathological conditions that can cause problems.
What exactly is epiphora (watery eyes), and what are the main causes?
Epiphora, or watery eyes, refers to the overflow of tears onto the face (excessive and uncontrolled flow on the cheeks). Dry eye and chronic blepharitis are the most common causes of epiphora. Additionally, malfunction of the meibomian glands with the production of poor – quality tears, allergies, trichiasis condition , alterations in the normal anatomical position of the eyelids (entropion or ectropion), malfunction of the lacrimal pump, or blockage of the nasolacrimal duct are other reasons that tears may accumulate in the eye.
How is epiphora (watery eyes) treated?
Epiphora (watery eyes) is considered a complex problem that significantly affects the quality of life and daily activities of many patients. A comprehensive and detailed clinical – diagnostic examination is necessary to accurately identify the real causes and determine the most appropriate therapeutic approach.
If epiphora is caused by an “everted” eyelid, it should be corrected. If the underlying cause is dry eye syndrome, treatment with artificial tears and other medications (e.g., oral medications) is recommended. In case of infection or inflammation, special eye drops may be prescribed. For a simple blockage of the lacrimal drainage system, microsurgical techniques (dacryoplasty) may be applied.
Finally, when a blockage of the nasolacrimal duct is detected, the modern surgical technique that provides a solution is dacryocystorhinostomy (DCR). Every blockage or narrowing of the nasolacrimal duct is bypassed with this specific intervention, stopping the bothersome epiphora (watery eyes). A DCR procedure can be performed in two ways, either externally (with a small incision in the skin) or endoscopically (through the nose, without a skin incision).
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