Why can’t I stop tearing?
Patients often come into our practice describing problems associated with excessive or constant tearing in one or both eyes. What they are referring to, is a condition called epiphora.
Epiphora is caused by either irritation or inflammation of the ocular surface, or can be due to an obstruction to tear drainage. Evidently, treatment differs depending on the cause.
Causes of irritation/inflammation to the ocular surface range from dry eyes, allergy, infection or ocular surface trauma. In this case, your optometrist/ophthalmologist can diagnose and prescribe an appropriate treatment regimen which may include tear supplements, antihistamines, antibiotics and/or anti-inflammatory eye drops. Tear obstruction can be caused by anatomical abnormalities. One of the most common is ectropion – which commonly occurs with aging, whereby the lower eyelid loses elasticity and turns away from the globe. This means the lower puncta (tear drainage pipework) is no longer in close apposition to the eyeball and can no longer effectively drain excess tears away from the ocular surface. This results in a back-log of tears on the ocular surface and overflow down your cheeks. In this case, surgery is the only way to restore normal function of the eyelid.
Another cause of obstruction to tear flow is punctal stenosis – which is where the tear drainage pipework becomes too narrow due to aging or scarring from infection. Narrow pipework means that tears cannot drain fast enough. This produces a backlog of tears especially in air-conditioning or windy conditions which promote excessive tearing. In this case the pipework needs to be expanded, which may require surgical intervention.
Sometimes a blockage can occur mid-way down the pipework – due to infection or simply from a collection of waste products. In this case, your tear drainage pipework may need irrigating or flushing with a specialized syringe to forcibly unblock the system.
No matter what the cause, your optometrist or ophthalmologist can diagnose and advise which treatment intervention is required. So next time you can’t stop tearing, don’t put up with it, visit your optometrist.
Till next time,
Phone: (02) 6643 2020
Address: 86 Prince Street, Grafton
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