Epiphora is an overflow of tears, usually caused by poor drainage of the tears from the eye into the nose. The most common cause is an obstruction of the nasolacrimal (tear) ducts, but the condition may also result from excess tear production, such as that which occurs in dry or windy conditions.
Other causes of excess tearing may be corneal disorders, lower eyelid looseness, weakness of facial muscles as the result of a stroke, and eyelashes rubbing on the cornea.
When the nasolacrimal duct is substantially or completely blocked, and causing symptomatic tearing, surgical treatment can be very effective. In partial blockage cases, the native nasolacrimal system can be stretched using silicone tubing. This can be done as an outpatient under mild sedation and local anesthesia.
In cases of complete (or near-complete) blockage, a new tear duct drainage system must be created. This procedure is called a dacryocystorhinostomy (DCR), and is also performed as an outpatient. During the DCR procedure, the obstruction in the duct is bypassed by creating a new passage directly into the nose. A temporary tube is then left in place to keep the new passage from scarring and closing.