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Watering Eye (Overflow Of Tears From Conjunctival Sac ) (Clinical…
Watering Eye
(Overflow Of Tears From Conjunctival Sac )
Etiology
Hyperlacrimation
Primary Hyperlacrimation
due to direct Stimulation of Lacrimal Gand
Parasympathomimetic Drugs
Tumours Of Gland
Reflex Hyperlacrimation
Affection of Lids
Stye , Trichiasis , Entropion
Affection of Conjunctiva
Conjunctivitis (Infective , Toxic , Allergic )
Affection of Cornea
Corneal Ulcer , Keratitis
Affection of Sclera
Episcleritis, Scleritis
Affection of Uveal Tissue
Iridocyclitis
Acute Glaucoma
Endophthalmitis , Panophthalmitis
Orbital Cellulitis
Central Lacrimation (Psychological) Emotional states
Epiphora (Inadequate drainage of Tear )
Physiological cause (Lacrimal Pump Failure )
due to Laxity Of Lower Lids
Mechanical Obstruction
at the level of
Punctum
Canaliculus
NLD
Punctal Causes
Eversion Of Lower Puntum ( Commonly seen in Old age )
Punctal Obstruction (Due to Prolonged use of Pilocarpine ,)
by Concretion , Foreign Body
Canaliculi cause
Actinomycetes Canalicullitis
NLD cause
Non Canalization (Congenital)
Acquired strictures & Stenosis
Cause of Lacrimal Sac
Dacryocystitis
Clinical Evaluation
Ocular Examination With Diffuse illumination with Magnification to RULE OUT CAUSE OF REFLEX HYPERSECRETION
REGURGITATION TEST
Pressure applied over Lacrimal Sac Area by index finger
Regurgitate fluid + ➡️ Obstruction at Lower End Of Lacrimal Sac / NLD
Flourescein Dye Disappearance Test (FDDT)
➡️Prolonged retention of dye in Conjunctival Sac ➡️ Mechanical obstruction
LACRIMAL SYRINGING TEST
Reflux of saline through Same Punctum ➡️ Obstruction at same punctum / Common Canaliculus
Reflux of saline through Oppposite Punctum ➡️ Obstruction at Lower Sac / NLD
Jones Dye Test ( NO VALUE IN CASE OF
TOTAL OBSTRUCTION)
Dacryocystography ➡️Valuable in Mechanical Obstruction
Radionucleotide Dacryocystography (LACRIMAL SCINTILLOGRAPHY) ➡️ Assess Functional Deficiency Of Lacrimal drainage system