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Year : 2022  |  Volume : 4  |  Issue : 1  |  Page : 52

Etiology and management of epiphora in an underserved, minority population

Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA

Correspondence Address:
Alberto G Distefano
Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, 85 East Concord St., 8th Floor, Boston 02118, MA
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/pajo.pajo_56_22

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Objective: There is value in understanding the common etiologies of epiphora within different patient populations as well as identifying barriers to adequate treatment and symptom relief. The primary goal of the study is to report common etiologies of epiphora and the impact of treatment in patients of a large, inner-city hospital. Methods: This is a retrospective review of 10 years of data from the charts of 516 adult patients. The most common diagnoses and interventions linked to this symptom were evaluated. Subjective symptom improvement and adherence to follow-up were also analyzed. Results: Three hundred (58.1%) patients carried a diagnosis of dry eye syndrome and, of these, 40.1% did not have other ocular findings to explain their epiphora. Conservative management (CM) was recommended to the majority (86.4%) of the study population. 27.5% of the 357 patients who received CM as the only intervention reported symptom improvement. 90.1% of patients who underwent DCR reported symptom improvement. Nearly half of the patients were lost to follow-up. Conclusion: Epiphora is a common symptom that may be multifactorial in etiology, making effective treatment a challenge. Reflex tearing secondary to ocular surface dryness was the most common etiology linked to epiphora in this study. Low rates of follow-up limit the ability to fully assess the impact of current interventions on symptoms. Addressing the socioeconomic barriers that lower patient adherence to follow-up should allow more effective treatment of epiphora.

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