Syndrome of Excessive Tearing from the Eye Socket (Epiphora)
Description of the Disease and Clinical Picture
 
Epiphora represents the occurrence of excessive tearing from the eye socket. Epiphora most often occurs as a result of intense tearing (hypersecretion), or increased production of tear film due to inflammatory processes (especially ocular allergies). Epiphora frequently occurs in cases of atresia of the tear ducts, lacrimal puncta, micropuncta, or in obstruction of the tear ducts; these are all conditions where the drainage of tear film is hindered, causing tears to overflow from the eye socket. Also, in the case of laceration of the lower eyelid, an anatomical defect can occur, leading to the inability to retain the tear film and subsequent excessive tear drainage.
 
In many dog breeds, especially dwarf ones, hairs of the medial eye canthus touch the cornea and act as a "drain" for tear flow. In these breeds, the anatomy of the orbit and eyelids contributes to difficult tear drainage and the occurrence of epiphora (short snout, pronounced stop, large eyes, and slightly protruding eyeballs). Dog breeds prone to this problem are Shih Tzus and Lhasa Apsos (brachycephalic breeds), miniature poodles, Maltese, and Bichons. In cats, this condition most often occurs as a result of brachycephalic head conformation and specific eyelid conformation (especially in Persian cats).
 
In dogs with epiphora, a brownish, moist trail is observed from the medial eye angle towards the snout. Constant dampening of this area can lead to dermatitis.
 
Therapy
First, hypersecretion of tears must be ruled out as the cause of the clinical picture. Then, the reason for epiphora is determined. Under magnification, the eye is examined, paying special attention to the lacrimal punctum, present lacerations, or other anatomical defects. The patency of the nasolacrimal ducts is checked using a fluorescein test, cannulation, and irrigation of the duct.
 
If hairs are the cause of epiphora, they are removed by cryoepilation, or surgical correction of the skin in that area is performed. If it is a question of obstruction of the nasolacrimal system, cannulation and irrigation are carried out, or the obstacle is removed with special instruments or surgery. A missing lacrimal punctum sometimes needs to be surgically reconstructed.
 
Idiopathic epiphora can in some cases be controlled medicinally (systemic and topical anti-allergy drugs, tetracyclines, metronidazole) and can be resolved surgically (by creating a fistula between the medioventral palpebral conjunctiva of the lower eyelid and the nasal cavity).
 
In miniature dog breeds prone to epiphora, proper eye and hair care around the eyes is usually sufficient. In severe cases, chronic facial dampness can lead to facial skin inflammation.
 
Please contact our specialty veterinary ophthalmology hospital Animal Eye Consultants
of Iowa (animaleyeiowa@gmail.com) in USA or Oculus Veterinary Specialty Hospital
(oculusklinika@gmail.com) in Serbia, Europe to schedule an appointment so your pet
can be seen.