[KoK! Health] When the Cold Wind Blows, 'Crybaby'... Causes and Treatments of Epiphora

Excessive Tear Secretion Due to Tear Gland Stimulation
Also Occurs Due to Abnormalities in Tear Drainage System

[Asia Economy Reporter Lee Gwan-joo] During autumn, the large temperature difference between day and night and the dry, cold wind irritate the eyes, causing an increasing number of patients to visit hospitals with symptoms of uncontrollable tearing. If you experience excessive tearing or discomfort more than usual during this period, it is advisable to visit a hospital for a tearing disorder examination.

Generally, tears are produced by the lacrimal glands at an average of about 5cc per day without any particular stimulation. Tears supply moisture to the eyes, provide lubrication between the eyelids and the eyeball, and help wash away fine dust and harmful substances. After moistening the eyes, tears drain into the nasal cavity, but usually, the amount of tears is not large, and they flow naturally through the tear ducts, so people do not feel it.

However, if tears are produced excessively compared to usual or if the tear ducts are blocked, drainage is impaired, leading to 'epiphora (tear duct obstruction).' The causes of epiphora are broadly divided into two categories. One is excessive tear secretion due to overstimulation of the lacrimal glands, and the other is obstruction of the tear drainage system.

Causes of Epiphora: Excessive Tear Secretion and Abnormalities in Drainage System

Specifically, excessive tear secretion can be caused by excessive nerve stimulation of the lacrimal glands, eyelash irritation, or reflex tearing. Reflex tearing refers to the production of tears in response to external stimuli in patients with dry eyes who have a reduced basal tear film that lubricates the eyes. Tear drainage disorders refer to a condition where one or more parts of the tear drainage system?the puncta, canaliculi, lacrimal sac, or nasolacrimal duct?are obstructed or functionally impaired, causing tears to wet the eye surface but not drain properly.

Professor Kim Gye-jung, an ophthalmologist at Myongji Hospital (left), is treating epiphora.
[Photo by Myongji Hospital]

Epiphora is diagnosed by examining the eye surface with a slit-lamp microscope. Tests include flushing water through the tear ducts or using special probes to examine the tear drainage system. Additionally, dacryocystography may be performed to determine the degree of narrowing and the location of blockages in the tear ducts. Based on the test results, treatment methods and timing are decided. Eyelid problems such as eyelash irritation can be treated with eyelid correction therapy, and symptoms of reflex tearing can be alleviated by using artificial tears.

On the other hand, most tear drainage disorders require surgical treatment. Procedures such as 'nasolacrimal duct probing' to open blocked parts between the nose and tear duct, 'silicone tube intubation' to widen narrowed tear ducts by inserting silicone tubes, 'dacryocystorhinostomy' to create a passage from the lacrimal sac to the nasal cavity, and 'conjunctivodacryocystorhinostomy' connecting the conjunctiva, lacrimal sac, and nasal cavity help facilitate tear drainage.

Dry and Cold Autumn Air: Use Artificial Tears and Maintain Hygiene

The dry and cold air in autumn makes the eye surface more prone to dryness compared to the hot and humid summer. This can increase tear secretion and worsen epiphora. If you have dry eye syndrome, using artificial tears just before activities that dry the eyes, such as reading or watching TV, can be helpful. Also, since repeated inflammation of the tear ducts and surrounding areas can lead to tear duct obstruction, thorough personal hygiene management is necessary to prevent conjunctivitis or blepharitis.

Professor Kim Gye-jung of Myongji Hospital's Department of Ophthalmology explained, “Epiphora causes blurred vision due to accumulated tears and discomfort in daily life as tears flow every time you blink. Especially, if inflammation occurs in the lacrimal sac due to tear duct obstruction, purulent discharge may be released, and pain and swelling may persist, so it is important to visit a hospital promptly.”