Деякі причини сльозотечі
Cause | Suggestive Findings |
|---|---|
Disorders causing excess tear production | |
Dry eyes with reflex tearing | Worse on cold or windy days or with exposure to cigarette smoke or dry heat Intermittent foreign body sensation In patients with a disorder known to cause dry eyes (eg, blepharitis) |
Ocular surface irritation (eg, allergic conjunctivitis, corneal abrasion or erosion or ulcer, foreign body, hordeolum, infectious conjunctivitis, irritant chemicals, keratitis, trichiasis, irritation with punctate lesions due to paresis of blink muscles as in facial nerve palsy) | Grittiness Redness In patients with corneal lesions, pain, constant foreign body sensation, and photophobia |
Itching Possibly papillae on tarsal conjunctiva | |
Nasal irritation and inflammation (eg, allergic rhinitis, upper respiratory infection) | Rhinorrhea, sneezing, nasal congestion |
Disorders causing nasolacrimal drainage obstruction | |
Symptoms that begin shortly after age 2 weeks | |
Idiopathic age-related nasolacrimal duct stenosis | Usually normal examination except for evidence of obstruction |
Nasal pain Often swelling, redness, and warmth over the lacrimal sac and, with palpation, tenderness and expression of pus | |
Tumors | Hard mass in the nasolacrimal duct system, particularly in older adults |
Other causes of nasolacrimal drainage stricture or obstruction | Often risk factors (eg, burns, injuries, certain medications) Often no characteristic examination findings other than obstruction |
Disorders causing decreased drainage without obstruction | |
Misalignment between tear film and puncta (eg, ectropion, entropion) | Usually visible on examination |