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Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Epiphora: an evidence based approach to the 12 minute consultation
K J Blackmore1, G Ainsworth, A K Robson
1Department of Otolaryngology-Head and Neck Surgery, Cumberland Infirmary, Carlisle, UK. kblackmore@nhs.net
Summary
Epiphora, or a watering eye, requires accurate assessment for proper management. Surgical intervention, like dacryocystorhinostomy (DCR), is often necessary for obstructed cases, with endoscopic DCR showing comparable outcomes to traditional methods.
Area of Science:
- Otolaryngology
- Ophthalmology
Background:
- Epiphora, characterized by a watering eye, can result from reflex tearing or impaired tear drainage.
- While ophthalmologists manage most cases, otolaryngologists play a crucial role in assessment and treatment.
- Understanding the underlying cause is essential for effective management.
Purpose of the Study:
- To review the diagnosis, investigation, and management of epiphora.
- To highlight the otolaryngologist's role in managing patients with epiphora.
Main Methods:
- Literature search of MEDLINE and Cochrane databases (up to October 2009).
- Keywords included 'epiphora,' 'functional epiphora,' diagnosis, investigation, management, treatment, intervention, and surgery.
- English language articles and senior author biographies were reviewed.
Main Results:
- Accurate assessment of obstruction is key for appropriate management.
- Medical treatment with nasal steroid spray may be beneficial.
- Most obstructed cases require surgical intervention, such as dacryocystorhinostomy (DCR).
Conclusions:
- Dacryocystorhinostomy (DCR) is the primary surgical treatment for obstructed epiphora.
- Powered endoscopic DCR demonstrates outcomes comparable to external DCR.
- Correctly identifying the obstruction site and severity guides successful treatment strategies.
