Janaki was
shedding tears. Her friend Charu, however, noticed something peculiar. Janaki
was neither unhappy nor was she shedding tears from both eyes. But she couldn't
help noticing the steady trickle of water from her friend's left eye.
“Why are you crying?”
she asked. Janaki wiped her eye with the hanky and smiled, “I'm not crying! My
left eye has been constantly watering for the last six months. My eyelids are
glued shut in the morning and I have to wash them clean to open them. So I'm
stuck with my constant companion: my hanky.”
Blocked duct
With Charu urging
her to see a specialist, Janaki consulted her ophthalmologist who referred her
to an oculoplastic surgeon. “Your tear duct is blocked and you have an
infection of the tear sac,” was the verdict. “You'll require surgery to correct
it”.
A common cause for
excessive tearing is an obstruction in the tear duct at the level of its
opening into the nose. In normal cases, a steady current of tears is constantly
passing over the eye and is cleared by the tear drainage system. An obstruction
causes a tear traffic jam and the pooled tears overflow from the corner of the
eye on the affected side. The stagnant tears are an ideal bed for bacterial
growth. Infections in the tear sac can sometimes result in a painful swelling
near the eye called acute dacryocystitis. More commonly, the infection is
longstanding resulting in an incessant purulent discharge. Swollen lids, pooled
tears and matted lashes cause the eye to appear shrunken.
In rare cases, the
infection can spread deeper and become life threatening. The infected tear sac
can, on occasion, rupture on the skin surface resulting in abnormal tear
drainage on to the cheek through a fistula.
Tear duct
obstruction affects not only adults but also infants. Babies do not normally
produce tears till the first four weeks. Hence any watering from a newborn's
eye needs to be examined.
In children
The tear duct
develops late in children and may take some time to open. In some cases, the
opening of the duct can be delayed resulting in excess watering and even
infections. Such obstructed ducts can be opened by systematic massaging of the
tear sac and medication. Sometimes the block does not open and may need further
intervention.
Janaki underwent a
Dacryocystorhinostomy or DCR, a surgery that creates a bypass channel between
the tear sac and the lining of the nose. It is a safe and effective procedure
that can be performed comfortably under local anaesthesia. The surgery took
just 45 minutes and she found a permanent cure to her problem. Being a local
anaesthetic procedure, she was allowed to go home after two hours of rest. A
couple of days later, she was back at work; this time without the hanky.
Source : thehindu dtd 17/03/2012 sapost
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