what is epiphora melbourne

What is Epiphora? – Everything You Need To Know

We’ve all experienced watery eyes for one reason or another. It might have been triggered by a particularly emotional movie or perhaps something flew into your eye. In many cases, watery eyes are not unusual and can often be due to something easily identifiable, innocent, and fleeting. However, on occasion, you may find your eyes routinely overflowing with tears for no good reason, and it’s these occasions that may bring you to your eye care professional where you might hear the term “epiphora”. So, what is epiphora?

 

What is Epiphora?

Epiphora is the medical term for the overflow of tears from the eyes or watery eyes. It can occur due to an eye condition or disease, or it may be a reflexive reaction in an attempt to wash away some sort of irritation to the eyes, such as dust or chemical fumes. 

Causes of watery eyes can include:

  • Conjunctivitis: watery eyes from allergic conjunctivitis is usually easily identified as they’re often accompanied by other allergy symptoms such as itching and redness of the eyes. You may also have the typical symptoms of hayfever, such as sneezing and a runny nose. Viral conjunctivitis also tends to present with watery eyes alongside redness and itching or burning; you may have also had a recent cold or flu. 
  • A foreign object in the eye: the natural reflex of the eye when encountering a foreign particle is to produce tears in order to flush it away; there may be accompanying discomfort or irritation. 
  • Trauma to the eye: this can be as mild as accidentally brushing a finger against your sensitive cornea or as severe as a laceration to the eye. Depending on the extent and type of trauma, you can expect other symptoms including pain, redness, and decreased vision.
  • Infection or inflammation to the cornea: known as keratitis, this can be from a variety of causes including bacterial or viral. Keratitis is often accompanied by a sore eye, glare sensitivity and potentially decreased vision. causes what is epiphora melbourne
  • Dry eye disease: although counterintuitive when considering the definition of what is epiphora, a dry eye’s surface triggers a reflex to produce more tears, which may then end up overflowing and resulting in a watery eye. Addressing the epiphora then becomes a matter of actually treating the eyes for dryness.
  • Changes to the structure or function of the nasolacrimal system or eyelids: ageing, facial trauma, or unusual growths may impede the normal drainage of tears from the surface of the eye, leading to epiphora. There can often be no other outwardly noticeable abnormalities. Such cases may require the attention of an eye specialist and oculoplastic surgery. 

 

The Nasolacrimal System and Eyelids

The nasolacrimal system of the eye is responsible for the production of tears and its drainage from the surface of the eye. The lacrimal gland sits just above the top eyelid towards the outer corner of the eye and secretes its tears onto the surface of the eyeball. Tears play an important part in the health of the eye and are significantly more than just saline, providing lubrication, protection, and various nutrients and immune factors to the surface of the eye. Due to gravity, these tears eventually pool along the margin of the bottom eyelid. The blinking motion of the eyelids flushes these tears towards the inner corners of your eyes, which contain two small openings known as puncta on the top and bottom eyelids; from there the tear fluid then drains via a system of ducts through the nose and down the throat. 

Any dysfunction or alteration to the structure of the nasolacrimal system or the eyelids has the potential to induce a watery eye as it impedes the normal drainage of tears. This can occur in one eye and not the other, or be present in both eyes but more pronounced in one. Issues to these parts of the eye may only be able to be resolved with oculoplastic surgery, a subspecialty of ophthalmology that cares specifically for the eyelids and associated anatomy. 

An eye specialist in oculoplastic surgery is able to assess the function of your eyelids, including whether they are able to close in such a way that efficiently moves tears towards your puncta, whether they are sitting in an appropriate position against your eye’s surface, and whether there are any bumps or distortions along the lid that may disrupt the normal drainage of tears. Surgical procedures such as tightening of a loose lower eyelid such that it sits well-positioned against the eye, known as blepharoplasty, or excision of a disruptive bump along the eyelid margin may be the solution in these cases. 

Often a narrowed section of the nasolacrimal system is the underlying reason for epiphora and requires an experienced ophthalmologist in oculoplastic surgery to treat the obstructed area. Punctoplasty and an insertion of a stent may be necessary to widen a narrowed punctum, or in some cases, an entirely new channel from the eyes to the nose may be surgically constructed in a procedure known as a dacryocystorhinostomy.  

Rather than putting up with a persistent, bothersome watery eye with tears constantly flowing down your cheek, having an eye examination by an appropriately experienced eye care professional can identify what is your epiphora caused by and how it can be best treated.

 

 

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

corneal infection melbourne

All About Corneal Infection And What Should You Do About It

A corneal infection is no laughing matter. While some corneal infections cause only a mildly irritated eye, other cases can present as a serious eye health concern with the potential to cause permanent vision loss. A corneal infection may arise due to a number of reasons, including bacterial or viral infections, or even due to fungi or parasites. 

The cornea is the transparent dome of tissue at the very front surface of the eye. This anatomical structure is the first surface that light passes through in order to reach the back of the eye and form what we call vision; disruption to the clarity of this tissue can be a real problem for your sight. The cornea is also the most sensitive structure, something that becomes apparent when even the finest eyelash falls into your eye.

You may come across the word “keratitis” when reading about corneal infections – keratitis technically refers to any inflammatory condition of the cornea and may or may not involve an active infection. However, all corneal infections involve some degree of inflammation at some stage of the disease, and so will often include keratitis in its medical naming.  

 

Causes of Corneal Infection 

Infectious causes of keratitis include:

 

Viral infections

The most common viruses involved in viral infections of the cornea are herpes viruses and adenoviruses – viruses that are often responsible for conditions beyond eye health. Type 1 herpes simplex is the same strain that causes cold sores and also has the ability to cause an eye infection known as herpes simplex keratitis.

Another virus of the herpes family is varicella zoster virus, which is also the virus behind conditions like chickenpox and shingles. Unfortunately, both these viruses are never cleared from the body but instead lie dormant; reactivation of the virus from various triggers can cause recurrent infection and inflammation, which can be sight-threatening. Adenoviruses are very common viruses often responsible for symptoms such as sore throat, pneumonia, and the common cold. Viral infections of the eye associated with adenoviruses are highly contagious, so much so that an eye infection caused by adenoviruses is called “epidemic keratoconjunctivitis”. 

causes corneal infection melbourneViral corneal infections often present as a sore, watery, red eye. There is also often glare sensitivity and blurred vision in the affected eye. The infection may be present only on one side, however, due to the highly contagious nature of the adenovirus, it can be expected to soon spread to the other eye. Patients with herpes-associated keratitis may have a history of cold sores while patients with adenoviral keratoconjunctivitis may report having had a recent cold or been in contact with someone else with a cold. Unlike herpes keratitis, which is treated with antiviral medication, there is no consensus on effective treatment for adenoviral keratitis, which will often self-resolve over a couple of weeks. 

 

Bacterial infections

Bacteria are the most common culprits of corneal infections, typically staphylococcus aureus and pseudomonas aeruginosa. Bacterial keratitis should never be ignored as it can have serious consequences for eye health, including permanent scarring and loss of vision. People who wear contact lenses, especially those with contact lens habits contrary to the recommendations of their eyecare practitioner, are at a greater risk of bacterial keratitis; additional risk factors include other causes of compromised eye health such as chronic dry eye, recent eye surgery, or eye trauma.  

Similar to a viral corneal infection, bacterial keratitis will also present with a painful, red eye but the discharge will often be of a pus or mucous consistency rather than watery. Depending on the site and severity of the infection, your vision may be significantly impaired from a large, central corneal ulcer, or perhaps only slightly blurry from the mucous discharge. 

 

Fungal infections

Corneal infections due to fungi can be more difficult to identify as it develops slowly, often presenting symptoms only days after the initial infection. However, the effect on eye health and vision can be devastating if not treated appropriately. Many cases of fungal keratitis are preceded with some sort of vegetation-related trauma to the eye, such as plant matter flicking into the eye during gardening or being scratched in the eye by a tree branch or leaf while outdoors. Contact lens wearers are also at a higher risk of contracting fungal keratitis, as are people who are immunocompromised, such as those using steroid medications. Common fungal pathogens include Candida, Aspergillus, and Fusarium. It’s been noted that the likelihood of specific fungal infections can vary by geography and climate. 

A fungal keratitis can present with the typical eye infection symptoms of pain, redness, glare sensitivity, tearing, and decreased vision. However, some cases actually present with very little pain or discomfort in the eye, which can delay diagnosis and prompt treatment. 

 

Parasitic infections

Luckily, parasitic keratitis is rare. The most common parasite to cause keratitis is acanthamoeba, a common, hardy protozoa found in water, soil, and even air. Similar to other types of infectious keratitis, contact lens wearers are at an increased risk of contracting acanthamoeba keratitis, particularly when proper lens disinfection and hygiene is disregarded. 

The distinguishing symptom of acanthamoeba keratitis is severe pain, disproportionate to the other symptoms such as watering, redness, and glare sensitivity; this is thought to be due to the microorganism specifically targeting the corneal nerves. If not treated promptly and appropriately, uncontrolled Acanthamoeba keratitis can cause permanent loss of vision in the affected eye.

 

Contact Us Today

The best thing to do if you think you may have a corneal infection is to see your eyecare practitioner immediately. Depending on the underlying cause of the keratitis, its severity, and your risk of permanent vision loss, corneal infections may be treated with topical eye drop medications, systemic medications, or a combination of both.