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diseaseExcessive Tear Secretion
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bubble_chart Overview

Excessive tear secretion is the result of hyperactive lacrimal gland function, but the meanings of tearing and epiphora caused by it are different. Generally, apart from the annoyance of constantly wiping away tears, there are no adverse reactions. A few patients may develop complications such as conjunctivitis, blepharitis, and lower eyelid eczema.

bubble_chart Etiology

There are many causes of excessive tear secretion:

1. Physiological reflex: Excessive tearing can occur due to emotional impulses, vomiting, coughing, or yawning.

2. Neural reflex: Chemical or physical stimulation of the conjunctiva or cornea, such as dust-like foreign bodies, irritating gases, cold, heat, or strong light, can trigger neural reflex tearing. Similarly, stimulation of the nasal cavity, sinuses, or oral mucosa by corrosive gases or mechanical factors can also induce reflex tearing via the trigeminal nerve.

3. Drug-induced reaction: The use of strong parasympathomimetic agents such as carbachol, neostigmine, or organophosphorus pesticides can cause drug-induced tearing.

4. Lacrimal gland disorders: Conditions like lacrimal gland cysts, tumors, or early-stage Mikulicz syndrome often present with tearing, though lacrinal glanditis does not necessarily cause tearing.

5. Central reflex: Excessive mental excitement, such as in hysteria patients, often leads to this type of tearing. Newborns, who have not yet developed such mental factors, do not shed tears when crying for the first few months, only doing so after several months.

6. Symptomatic tearing: Some systemic diseases, such as conjunctival hyperemia and tearing in tabes dorsalis (possibly due to supranuclear facial nerve lesions or trigeminal nerve stimulation), or early-stage hyperthyroidism, also fall into this category.

bubble_chart Clinical Manifestations

Treat according to different disease causes, remove the disease causes, and control the secretion of tears.

1. For patients with tearing

(1) Drug treatment: Take strong sedatives such as perphenazine, meprobamate, and chlordiazepoxide. Adults take 2.5–5 mg orally each time, three times a day.

(2) Avoid emotional stimulation, treat eye inflammation, and reduce reflex tear secretion.

(3) Wear tinted glasses to avoid strong light stimulation.

(4) The lacrimal gland outlet can be sealed by electrocoagulation to induce lacrimal gland atrophy, but this should be done cautiously to prevent side effects.

2. For patients with epiphora

(1) Abnormal position of the lacrimal punctum can be corrected by electrocoagulation to restore normal inversion. For those with blocked lacrimal canaliculi, threading and intubation can be performed, with the tube retained for 15 months, and regular lacrimal duct irrigation with 2% methylcellulose solution. For extensive lacrimal duct obstruction, a metal tube can be inserted from the caruncle, passing through the lacrimal sac area and the lacrimal duct into the inferior nasal meatus.

(2) Drug treatment: For infectious inflammation of the lacrimal duct, antibiotic eye drops or lacrimal duct irrigation can be used, along with systemic administration of penicillin and streptomycin, and corticosteroids if necessary.

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