Symptomatic epiphora

Abstract

Symptomatic epiphora is presented as a clinical and pathological problem. A suggested scheme of investigation is described. A series of clinical examinations based on such a scheme has revealed two main groups of case other than those of blocked naso-lacrimal duct. One of the group comprised many cases which remained undiagnosed but the other group of cases was postulated as suffering from "naso-lacrimal catarrh", a low-grade congestion and swelling of the mucous membrane of the conjunctiva, canaliculus, lacrimal sac, and/or naso-lacrimal duct. A clinical analysis of each of these clinical groups led to the following findings: (1) A few men and a larger number of women are anatomically predisposed to a blockage of the naso-lacrimal duct. (2) The diagnosis of a blocked naso-lacrimal duct is more common when the condition is unilateral, and is most often seen in females; that of nasolacrimal catarrh is more common when the condition is bilateral, and occurs most frequently in male patients. (3) Many ducts which are apparently blocked respond to pressure syringing, which is a useful diagnostic and therapeutic procedure and is not considered dangerous. (4) The conservative treatment of naso-lacrimal catarrh as practised by the author in 36 cases with a demonstrable defect of drainage was followed by objective evidence of cure in sixteen cases.