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Causes of epiphora are any that cause either overproduction of tears or decreased drainage of tears, resulting in tearing onto the cheek. [2] This can be due to ocular irritation and inflammation (including trichiasis and entropion) or an obstructed tear outflow tract, which is divided according to its anatomical location (i.e., ectropion, punctal, canalicular or nasolacrimal duct obstruction).
Excessive tearing is the most common complaint of patients with nasolacrimal duct obstruction, followed by acute or chronic infections. [3] Pain at the side of the nose suggests dacryocystitis . Nasolacrimal duct obstruction is more common with increasing age and more common in females than males.
The resulting loose, excess conjunctiva may mechanically irritate the eye and disrupt the tear film and its outflow, leading to dry eye and excess tearing. [2] A correlation may also exist between inflammation in the eye and conjunctivochalasis, though it is unclear whether this correlation is causal.
It is usually caused by allergies or viral infections, often inciting excessive eye rubbing. Chemosis is also included in the Chandler Classification system of orbital infections. If chemosis has occurred due to excessive rubbing of the eye, the first aid to be given is a cold water wash for eyes. [citation needed] Other causes of chemosis include:
One may experience excessive tearing such as if something got into the eye. These reflex tears will not necessarily make the eyes feel better since they are the watery tears that are produced in response to injury, irritation, or emotion which lack the lubricating qualities necessary to prevent dry eye. [4]
With the eye generally profusely watering, the type of tears being produced have little adhesive property. Water or saline eye drops tend therefore to be ineffective. Rather a 'better quality' of tear is required with higher 'wetting ability' (i.e. greater amount of glycoproteins) and so artificial tears (e.g. viscotears) are applied frequently.
Watery eyes – due to excessive tearing. [7] Red eyes – due to dilated blood vessels on the sclera. [7] Swollen eyelids – due to inflammation. [7] Crusting at the eyelid margins/base of the eyelashes/medial canthus, generally worse on waking – due to excessive bacterial buildup along the lid margins. [4] [5] [7]
Periorbital puffiness, also known as puffy eyes, or swelling around the eyes, is the appearance of swelling in the tissues around the eyes, called the orbits. It is almost exclusively caused by fluid buildup around the eyes, or periorbital edema. Minor puffiness usually detectable below the eyes only is often called eye bags.