[Click! Health] "Tears Without Crying"... Epiphora May Also Cause Inflammation

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[Asia Economy Reporter Kim Young-won] Among adults aged 50 and older, there are cases where tears flow despite not crying, causing discomfort. This symptom is called 'tear disorder' or 'epiphora,' and it worsens in cold or windy weather and dry environments like these days.

According to the Health Insurance Review and Assessment Service, the proportion of epiphora patients by age group is 1.4% in their 20s, 2.4% in their 30s, 7.3% in their 40s, 20.3% in their 50s, 29.6% in their 60s, and 24.9% in their 70s, showing a sharp increase starting from the 50s.

Epiphora is divided into excessive tear production and decreased tear drainage capacity. Excessive tear production occurs due to central nervous system diseases, reflex tearing caused by corneal irritation, or inflammation or tumors of the lacrimal gland. The most common cause of excessive tear production is reflex tearing due to insufficient basal tear secretion, such as in dry eye syndrome. This is treated by blocking factors that cause dryness, such as bright light and heater wind, and using artificial tears.

Decreased tear drainage capacity occurs when there is a problem anywhere along the drainage pathway from the eye to the nose. It can be blocked by inflammation, trauma, or postoperative scarring, but in most cases, the exact cause is unknown. In particular, in infants, congenital nasolacrimal duct obstruction can occur when the valve at the end of the nasolacrimal duct is not open from birth.

The most common symptom of tear duct obstruction is epiphora. If the obstruction is not severe, tears may accumulate only inside the eye, but if severe, tears can flow down the cheek to the extent that wiping with a towel is necessary. If symptoms appear even indoors, severe tear duct obstruction can be suspected. In addition to epiphora, tear duct obstruction may cause eye redness, chronic eye discharge, pain, or swelling near the lacrimal sac.

If tear duct obstruction is not treated promptly, tears accumulated on the eye can cause blurred vision and frequent wiping, significantly interfering with daily life. Continued epiphora can lead to purulent discharge in the lacrimal sac, causing various chronic inflammations such as persistent eye discharge. Constant rubbing or wiping of the eyes to remove tears can cause conjunctivitis and even dermatitis around the eyes. Acute dacryocystitis can cause severe redness and pain.

Most cases of epiphora caused by tear duct obstruction require surgical treatment. Professor Baek Se-hyun of the Department of Ophthalmology at Korea University Guro Hospital explained, "The surgical method is determined according to the location and degree of tear duct obstruction. If symptoms have lasted relatively briefly, within 3 to 6 months, and the obstruction is partial, surgery to widen the narrowed tear duct by inserting a silicone tube can be performed."

He added, "If the nasolacrimal duct is completely blocked and symptoms persist for more than six months, treatment with silicone tube insertion alone is difficult, and surgery to create a new pathway for tears to drain is performed."

Professor Baek advised, "Epiphora usually occurs due to aging, so there is no special prevention method. However, if symptoms such as epiphora or chronic eye discharge occur, it is important to visit an ophthalmologist as soon as possible to receive necessary examinations and appropriate treatment in a timely manner."