WATERY EYES & TEAR DUCT PROBLEMS

Causes

1. Irritation: This causes an increase in tear production. Such conditions include extra eyelashes, ectopic cilia, conjunctivitis, entropion, corneal diseases.

2. Decreased tear drainage: This causes an overflow of the tears. Tear duct blockages, punctal atresia, medial entropion, are causes for the decreased drainage.

Diagnosis

1. Magnified eye examination: For examining the eyelids, conjunctiva, tear duct openings, and the eyeball for any abnormalities.

2. Schirmer tear test: This test measures the tear production and shows if the amount of tears produced is normal, increased, or low.

3. Fluorescein stain: Is applied to the tear film to test if the tear duct is open. If the green stain comes through to the nose this lets us know that the tear duct is open. If no stain comes through to the nose the next step is to flush the tear duct.

Treatment

1. Blocked Tear Duct - Tear duct flush: under light anaesthetic the tears ducts can be flushed. In some cases it is necessary to pass a cannulae down into the tear duct to try and clear the tear duct. In some cases the tear duct is blocked. Sometimes cases the blockage can be cleared, this resolves the problem. However, it is possible for the tear ducts to block up again. In some cases it is not possible to unblock the tear duct. In these cases it may be worthwhile trying to flush the duct again 2 to 3 weeks later. In some cats with a history of “cat flu” we find that the tear ducts are totally scarred. There is no treatment for this.

Punctal Atresia

2. Lazy Tear Ducts - These are cases in which we can find no causes of irritation that might be causing the watery discharge. In these cases there is no passage of the fluorescein dye through to the nose. With the tear duct flush the ducts are found not to be blocked, and the flushing solution comes easily from the nose. In these cases we believe that the tear ducts are lazy. We believe that the tear duct has an active pumping mechanism to help drain away the tears. There is no specific treatment for lazy tear ducts. It has been suggested that it may be worthwhile trying to massage the inside corner of the eyelids.

Breed predisposition

3. Tear duct punctal atresia Punctal atresia develops where the opening of the tear duct does not form. Golden retrievers and American Cocker Spaniels are the most affected breeds. Surgery is required. With the aid of an operating microscope a new opening is created. In some cases the new opening will scar over, in these cases a cannulae is then placed into the new opening. In some cases the eye can still be watery even when the new puncta is working. This is due to the tear duct being lazy.

Breed Predisposition

Correcting causes of increased tear production

The most common cause of increased tear production is conjunctivitis. Long term treatment with cortisone drops is usually required in dogs. Cats usually require a prolonged course of antibiotics to treat an underlying infection, and they may also require drops to reduce the reaction. In some with cats they have chronic viral conjunctivitis which is very difficult to treat or even control.

Other causes of irritation to the eye include entropion, ectropion, extra eyelashes, ectopic cilia and hairs on the inside eyelid corner. In most cases surgery is required to correct these problems. (See Plastic Eyelid Surgery)

Tear Stain Cleaners From time to time various solutions and cleaners have been suggested for tear staining. We have found none of these to be effective. The best method is to do is to wipe any discharge 2 to 3 times daily. This tear staining does not seem to cause any problems; it is more of a cosmetic problem, occasionally may cause dermatitis.