Clinical Services

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  • Tearing

    There are many reasons why someone may have “epiphora” (tearing that runs down the face). Often people tear as a result of irritating ocular surface disease, even dry eye can cause reflex tearing. Other common reasons are lower eyelid laxity, ectropion, entropion, or blockages in the tear ducts.

    Children are frequently born with obstructed tear ducts. This leads to constant tearing, and mucous accumulation along the eyelids. Most of these obstructions will resolve spontaneously and the tearing and mucous will cease.

    In fact, 90% will resolve by the time the child is one year old. Resolution of the obstruction can be aided by regularly massaging the lacrimal sac at the inside corner of the eyelids. This can create a fluid pressure wave that can open the tear duct. However, if it does not resolve by the time that they reach one year of age or if the tearing and mucous discharge is severe then they may need surgery to prevent future infections.

    Surgical options for children with tearing include probing the nasolacrimal duct in order to open the blockage. Silicone tubes may be inserted, and an infracture of the inferior turbinate (bone in the inside of the nose at the opening of the tear duct) may be performed depending on the severity of the obstruction.

    Adults frequently get blockages of the tear ducts as well. This may be partial or complete and leads to annoying tearing and blurred vision. There is also a higher risk of infection within the lacrimal system when a blockage is present. A dacryocystorhinostomy (bypass for the tear ducts) is performed when there is a blockage in the nasolacrimal duct. This is typically performed under general anesthesia through a 1.5-2cm incision that is hidden in the inner lower eyelid crease. A separate opening is created from the lacrimal system to the nose for tear flow and silicone tubes are passed through the opening to keep it open during the healing process. If the blockage is closer to the eyelids a separate procedure called a conjunctivo- dacryocystorhinostomy may be necessary.

    Patients are frequently found to have multiple problems contributing to tearing, At your office visit, our oculoplastic surgeon will discuss these with you and develop an individual treatment plan addressing all of these causes of your tearing.