Epidemic keratoconjunctivitis and lacrimal excretory system obstruction

Epiphora is a common symptom associated with the acute phase of epidemic keratoconjunctivitis (EKC). Reflex lacrimal secretion occurs secondary to conjunctival or corneal inflammation. Acquired obstruction of the lacrimal excretory system may account for persistence of tearing after resolution of the acute inflammatory phase of the viral infection. Three cases of lacrimal excretory system obstruction after EKC are reported. Multifocal obstruction of the canaliculi and nasolacrimal duct is characteristic. Dacryocystorhinostomy (DCR) was required to relieve obstruction in all cases. Probing and corticosteroid irrigation may avoid the need for silicone intubation or conjunctivodacryocystorhinostomy in the management of canalicular obstruction. Persistent epiphora after EKC should raise clinical suspicion of acquired dacryostenosis. Early recognition may allow for optimal management.