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Dry eye with reflex tearing causes significant proportion of tearing cases
Ophthal Plast Reconstr Surg. 2011;27(3):155-157.
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A mechanism other than nasolacrimal duct obstruction was responsible for tearing in a significant proportion of patients, a study found.
Dry eye with reflex tearing was diagnosed in 40% of patients in a retrospective analysis of 150 consecutive patients referred for tearing. Nasolacrimal duct obstruction of both upper and lower systems was the predominant cause, occurring in 48.7% of subjects.
Other causes of tearing were classified anatomically as tear hypersecretion, ocular surface disease and lid abnormalities.
Patient examination included slit lamp exam, assessment of tear production, assessment of tear film quality and longevity, and evaluation of the patency of the nasolacrimal system. Schirmer test was used to diagnose the cause of tearing and identify appropriate treatment. Measurements of the Schirmer test strip were taken at 1 minute, 2 minutes and 3 minutes.
Two-thirds of patients reported improvement in their dry eye due to ocular lubrication, thus avoiding surgery that could intensify their symptoms over time, according to the study authors.