What is epiphora?
Epiphora means an overflow of tears from the eyes. It is a symptom rather than a specific disease and is associated with a variety of conditions. Normally, a thin film of tears is produced to lubricate the eyes and the excess fluid drains into the tear ducts (nasolacrimal ducts) located in the corner of the eye next to the nose. The tear ducts drain tears into the back of the sinuses and down the throat. Epiphora can be caused by either insufficient drainage of tears through the tear ducts, or by an excessive production of tears.
What are the signs of epiphora?
The most common clinical signs associated with epiphora are dampness or wetness beneath the eyes, reddish-brown staining of the fur beneath the eyes, odor, skin irritation and skin infection. Many owners report that their dog's face is constantly damp, and they may even see tears rolling off their pet's face.
How is epiphora diagnosed?
The first step is to determine if there is an underlying cause for the excess tear production. Some of the causes of increased tear production in dogs include conjunctivitis (viral or bacterial), allergies, eye injuries, abnormal eyelashes (distichia or ectopic cilia), corneal ulcers, eye infections, anatomical abnormalities such as rolled in eyelids (entropion) or rolled out eyelids (ectropion), and glaucoma.
"The first step is to determine if there is an underlying cause for the excess tear production."
Once the more serious causes for epiphora have been eliminated, it is necessary to determine if proper and adequate tear drainage is occurring. A thorough ocular examination is performed, paying special attention to the nasolacrimal ducts and nearby tissues, and looking for signs of inflammation or other abnormalities. The facial anatomy of the dog may play a role in this condition. Some breeds have flat or squished-in faces (brachycephalics) that do not allow the tear film to drain properly. In these pets, the tear film fails to enter the duct and simply rolls off the face. In other cases, the hair around the eyes physically obstructs the entrance to the nasolacrimal ducts, or debris or a foreign body forms a plug within the duct and prevents drainage of tears.
One of the simplest tests to assess tear drainage is to place a drop of fluorescein stain in the eye, hold the dog’s head slightly downward, and watch for drainage into the nose. If the drainage system is functioning normally, the eye stain should be seen in the nose within a few minutes. Failure to observe the stain does not definitively diagnose a blocked nasolacrimal duct, but it does indicate the need for further investigation.
How is epiphora treated?
If the nasolacrimal duct is suspected of being blocked, your dog will be anesthetized and a special instrument will be inserted into the duct to flush out the contents. In some cases, the lacrimal puncta or opening may have failed to open during the dog's development, and if this is the case, it can be surgically opened during this procedure. If chronic infections or allergies have caused the ducts to become narrowed, flushing may help widen them.
If the cause is related to another eye condition, treatment will be directed at the primary cause which may include surgery.
What can I do for the staining?
Many remedies have been recommended for removing or eliminating facial staining associated with excess tears,none have proven to be 100% effective. Some over-the-counter products have been suggested but have not been proven to be effective in research trials, and some may be harmful or injurious to the eyes.
"Keeping the area as clean and dry as possible, removing any build up, and trimming the fur short around the eyes can help."
Low doses of some antibiotics are no longer recommended due to the risk of developing bacterial antibiotic resistance, rendering these valuable antibiotics worthless for human and veterinary use. Short courses of appropriately dosed antibiotics can be reserved for severe cases if there is a secondary skin infection (redness, odor, or discharge).
Keeping the area as clean and dry as possible, removing any build up, and trimming the fur shourt around the eyes can help. There is also some evidence that daily probiotics can be helpful, but it can take a couple of months to see improvement. Do not use any product without consulting with your veterinarian. Avoid using any product containing hydrogen peroxide near the eyes since these products can cause severe damage if inadvertently splashed into the eyes.
What is the prognosis for epiphora?
Unless an underlying cause can be found and treated, most patients with epiphora will experience intermittent episodes throughout their life. If your dog's facial anatomy prevents adequate drainage of the tear film, it is likely that some degree of epiphora will persist despite all treatment efforts. In many cases, no significant problems may arise, and the tear staining may be cosmetic. Your veterinarian will determine the specific treatment options and prognosis for your dog.
