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Tear Duct Obstruction - Epiphora

Epiphora is an overflow of tears onto the face which is often caused by Tear Duct Obstruction due to insufficient tear film drainage from the eyes. This results in tears draining down the face rather than through the nasolachrymal system.

Causes of Tear Duct Obstruction

Tear Duct Obstruction results in the decreased drainage of tears and can be due to ocular irritation and inflammation. This includes both trichiasis and entropion or an obstructed tear outflow tract. These obstructions are diagnosed according to their anatomical location and include:


  • Ectropion Obstructions

  • Punctal Obstructions

  • Canalicular Obstructions

  • Nasolacrimal Duct Obstructions


Nasolacrimal Duct Obstructions are one of the most common forms of this eye condition and can be caused by ageing, conjunctivochalasis, infection, rhinitis, and trauma (including nasoethmoid fractures, maxillary Le Fort fractures and soft tissue trauma of the nose and eyelid).


A Medical Note! In infants, it is fairly common for the nasolachrymal duct to not open at birth. This condition can easily be treated by an Ophthalmologist. 

The Diagnosis of Epiphora

The Diagnosis of Epiphora and a Blocked Tear Duct is through clinical observation. In some cases, fluorescein dye can also be used to examine for punctual reflux.

The Treatment of Epiphora

The Treatment of Epiphora is dependent on the cause of the Tear Duct Obstruction. If it is caused by either an ectropion or entropion then lid repair is commonly used to rectify the condition. Punctal irrigation may also be required. If surgical intervention is needed, then this is in the form of a dacryocystorhinostomy in which the lachrymal sac is surgically joined to the nasal mucosa to restore lachrymal drainage.


In the case of infants suffering from nasolachrymal defects or a Tear Duct Obstruction, a nas lachrymal duct probe is used to clear the obstruction. In some cases, a tube replacement might be needed, and this will either be a temporary (or Crawford tube) replacement or a permanent (Jones tube) replacement.


Please book an appointment with Dr Aleksic, one of Cape Town’s Best Ophthalmologists, to find out more about the Treatment of a Tear Duct Obstruction.

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