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Summary
Watery eyes (epiphora) in the elderly can paradoxically indicate dry eye disease. Treatment with tear substitutes and punctal occlusion resolved symptoms in two patients, suggesting a link between dry eye and excessive tearing.
Area of Science:
- Ophthalmology
- Ocular Surface Disease
Background:
- Epiphora, or watery eye, is a common ophthalmic condition in the elderly.
- A paradoxical presentation of dry eye, with symptoms of dryness indoors and tearing outdoors, is observed in some patients.
Observation:
- Two patients, aged 76 and 58, presented with paradoxical epiphora despite confirmed dry eye diagnoses.
- Symptoms included excessive tearing, particularly outdoors, contrasting with indoor dryness.
Findings:
- Treatment with artificial tears, bromhexine, and lacrimal puncti occlusion effectively resolved the epiphora in both patients.
- This suggests that excessive tearing can be a manifestation of underlying dry eye syndrome.
Implications:
- Clinicians should consider dry eye as a potential cause of epiphora, even when paradoxical symptoms are present.
- This finding may lead to revised diagnostic and treatment approaches for watery eyes in geriatric populations.