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Functional epiphora: an under-reported entity.

Eiman Usmani1,2, Yinon Shapira3,4, Dinesh Selva3,4

  • 1Discipline of Ophthalmology and Visual Science, University of Adelaide, Adelaide, South Australia, Australia. usmani.eiman@gmail.com.

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|March 23, 2023
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Summary
This summary is machine-generated.

Functional epiphora, a non-anatomical delay in tear drainage, is as common as nasolacrimal obstruction. This study highlights its prevalence in Australian lacrimal clinics.

Keywords:
DacryocystographyDacryoscintigraphyEpiphoraEtiologyFunctional epiphoraNasolacrimal duct obstruction

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Area of Science:

  • Ophthalmology
  • Lacrimal System Disorders

Background:

  • Epiphora, or excessive tearing, can significantly impact quality of life.
  • Determining the precise cause of epiphora is crucial for effective management.

Purpose of the Study:

  • To investigate the etiological factors of epiphora in Australian adults.
  • To quantify the proportion of functional epiphora cases presenting to a tertiary lacrimal clinic.

Main Methods:

  • Retrospective review of 372 adult patients presenting with epiphora over a 10-year period.
  • Diagnostic workup included syringing/probing and lacrimal imaging (dacryocystography, dacryoscintigraphy).
  • Functional epiphora diagnosed by excluding anatomical obstruction and observing delays in tear clearance.

Main Results:

  • Post-sac obstruction and functional epiphora were the most frequent diagnoses (26% each).
  • Functional epiphora with post-sac delay was more prevalent than pre-sac delay (89% vs. 11%).
  • No cause was identified in 16% of cases; 11% had multifactorial causes.

Conclusions:

  • Functional epiphora is as common as anatomical nasolacrimal obstruction when advanced imaging is used.
  • Lacrimal imaging is essential for diagnosing functional epiphora and understanding tear drainage pathways.