Discipline of Ophthalmology and Visual Science, University of Adelaide, Adelaide, South Australia, Australia.
Department of Ophthalmology, Royal Adelaide Hospital and South Australian Institute of Ophthalmology, Adelaide, South Australia, Australia.
Int Ophthalmol. 2023 Aug;43(8):2687-2693. doi: 10.1007/s10792-023-02668-4. Epub 2023 Mar 23.
To determine the etiology of epiphora in a tertiary Australian lacrimal clinic and highlight the high proportion of 'functional' cases.
Single-center retrospective review: Records of adult patients presenting to a tertiary lacrimal clinic from January 2011 to February 2021 with epiphora were reviewed. Patients underwent testing with syringing/probing and lacrimal imaging to reach a diagnosis of functional epiphora. Functional epiphora was diagnosed based on the exclusion of alternate causes of epiphora on clinical examination, patent lacrimal syringing, normal dacryocystography, and delay on dacryoscintigraphy.
Five hundred and seventy-six symptomatic eyes of 372 adult patients (mean 66.2 ± 15.5 years, 63.4% females) with epiphora were evaluated for causes. Post-sac obstruction (stenosis/complete obstruction) and functional epiphora (non-anatomical delay) were the most common causes of presentations to the lacrimal clinic (26% each). Functional epiphora with post-sac delay was substantially more common than functional epiphora with pre-sac delay (89% vs. 11% of functional epiphora cases). In 16% of the cases, no cause for the epiphora was found while more than one cause (multifactorial) was present 11% of the time.
Functional epiphora was found to be as common as a nasolacrimal anatomical obstruction when lacrimal imaging is utilized.
确定澳大利亚一家三级眼科诊所溢泪的病因，并强调“功能性”病例的高比例。
单中心回顾性研究：对 2011 年 1 月至 2021 年 2 月期间因溢泪到三级泪道诊所就诊的成年患者的病历进行了回顾。对患者进行了冲洗/探查和泪道成像检查，以明确功能性溢泪的诊断。功能性溢泪是基于临床检查排除了溢泪的其他原因、泪道冲洗通畅、泪道造影正常和泪道闪烁显像延迟来诊断的。
对 372 例（平均年龄 66.2±15.5 岁，63.4%为女性）有溢泪症状的 576 只眼进行了病因评估。泪囊后阻塞（狭窄/完全阻塞）和功能性溢泪（非解剖性延迟）是最常见的泪道诊所就诊原因（各占 26%）。泪囊后延迟的功能性溢泪明显比泪囊前延迟的功能性溢泪更常见（89%比 11%）。在 16%的病例中，未发现溢泪的原因，而有 11%的病例存在多种原因（多因素）。
当使用泪道成像时，功能性溢泪与鼻泪管解剖阻塞一样常见。
