Tearing, or epiphora, can result from faulty tear drainage into the lacrimal tear ducts, or from overproduction of tears from the lacrimal gland. The most common cause of tearing is blockage of the lacrimal (tear) ducts located alongside the nose, which may result from inflammation, injury, tumors, or other reasons. Excess tearing can be a nuisance, and can also cause infection that may threaten vision if untreated. Tearing can frequently occur in infants, and with medical therapy and massage, the obstruction often resolves. If tearing persists after one year of life, probing and irrigation of the lacrimal system is recommended. If there is recurrence, oftentimes children will require a small silicone stent to be placed into the tear drainage system. In adults, nasolacrimal duct obstruction often requires a procedure called dacrocystorhinostomy, or DCR, which creates an opening from the tear duct into the nose. Treatment of partial lacrimal obstruction can be achieved with a balloon probe that dilates and opens the tear duct and placement of a stent if necessary. This problem is often seen in patients treated with certain chemotherapeutic drugs and should be evaluated by an ophthalmologist if tearing occurs. For complete obstruction, a procedure called a dacryocystorhinostomy is performed to open the tear duct and place a stent. This procedure can be performed under anesthesia endocsopically through the nose and sometimes requires a small incision on the side of the nose. These lacrimal procedures are often performed under general anesthesia. Another option is an artifical tear duct implant in cases of a congenitally underdeveloped tear duct, severe trauma, scarring, or narrowing of the existing tear duct.

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