Lacrimation Disorder: Causes, Diagnosis and Treatment

What is Lacrimation Disorder?

Lacrimation disorder refers to an abnormality in tear production or drainage. It can manifest as excessive tearing, known as hyperlacrimation, or reduced tear drainage due to blockages or dysfunction in the lacrimal system. 

The condition may occur temporarily due to allergies or persist because of structural or medical problems. In clinical terms, lacrimation disorder is classified under lacrimal disorders, which cover all conditions that affect the tear glands, tear ducts, and related structures. 

Early diagnosis is key to avoiding chronic discomfort and secondary eye infections.

Types of Lacrimation Disorders

Hyperlacrimation (Excessive Tearing)

Hyperlacrimation is a common type of lacrimation disorder where tears overflow due to irritation, infection, or structural issues. Causes may include eye allergies, foreign bodies, or inflammation of the eyelids. Sometimes, excessive tear production occurs when the eye tries to compensate for dryness or surface irritation.

Impaired Tear Drainage

In this type of disorder of the lacrimal system, tears are produced normally but fail to drain into the nasal passages because of a blocked tear duct or narrowing in the drainage channels. 

This condition often leads to watery eyes, recurrent eye infections, or persistent irritation. Surgical or minimally invasive treatments are sometimes required for effective relief.

Causes of Lacrimation Disorder

The causes of lacrimation disorder can vary widely, ranging from temporary irritations to chronic medical conditions. Common causes include:

• Allergies trigger watery eyes.
• Infections such as conjunctivitis or blepharitis.
• Blocked or narrowed tear ducts.
• Age-related changes affecting tear drainage.
• Eye injuries or trauma to the lacrimal system.
• Structural abnormalities are present from birth.
• Systemic conditions such as sinus disease or facial nerve disorders.

Understanding the root cause is crucial to determining the right treatment plan for managing lacrimation disorder.

Symptoms of Lacrimation Disorder

Allergies

Eye allergies are one of the most common triggers of lacrimation disorder. They cause excessive tearing, itching, redness, and swelling. Seasonal allergies, exposure to dust, or pet dander may lead to recurring watery eyes due to an overactive immune response.

Blepharitis

Blepharitis, an inflammation of the eyelids, is often associated with lacrimal disorders. It disrupts tear film stability, leading to watery eyes, irritation, crusting around the lashes, and swelling. This condition can make lacrimation disorder more persistent if not managed effectively with medical care.

Diagnosis of Lacrimation Disorder

Imaging Tests

Eye specialists may recommend imaging to assess blockages or abnormalities in the lacrimal system. Special dyes or contrast imaging help track tear flow, identifying whether impaired drainage is the cause of the lacrimation disorder.

X-rays

In certain cases, X-rays are used to evaluate the tear drainage pathway. They help in identifying narrowing or obstructions in the ducts. X-ray imaging provides vital details when diagnosing complex lacrimal disorders.

CT Scan

A CT scan provides a more detailed view of the disorder of the lacrimal system, especially when tumours, trauma, or sinus conditions are suspected. CT imaging is particularly helpful for planning surgical interventions in advanced cases of lacrimation disorder.

Treatment of Lacrimation Disorder

Treatment of lacrimation disorder depends on the underlying cause. Mild cases linked to allergies or infections may be treated with eye drops, antihistamines, or antibiotics. Warm compresses and eyelid hygiene help in conditions like blepharitis. 

For blocked tear ducts, procedures such as probing, balloon dacryoplasty, or dacryocystorhinostomy (DCR) may be required. In more complex cases, surgery to correct abnormalities in the lacrimal system ensures long-term relief from the disorder.

Risk and Prevention of Lacrimation Disorder

The risks of lacrimation disorder include chronic eye infections, discomfort, blurred vision, and reduced quality of life. Preventive measures include:

• Protecting the eyes from allergens, dust, and pollutants.
• Treating eye infections promptly.
• Practising proper eyelid hygiene to prevent blepharitis.
• Regular eye check-ups for early detection of lacrimal disorders.

By maintaining good eye care practices, many cases of lacrimation disorder can be prevented or controlled before they progress.

When to Visit a Doctor for Lacrimation Disorder

You should seek medical help if watery eyes persist for more than a few days and are accompanied by pain, swelling, or frequent infections. Any sudden onset of excessive tearing, especially after trauma or in older adults, should be promptly evaluated. 

Since lacrimation disorder can indicate a more serious disorder of the lacrimal system, professional evaluation ensures appropriate treatment and prevents complications.