Epiphora

Overview

Epiphora is a common condition in pets characterized by excessive tearing or tear overflow from the eyes. This condition occurs when tears cannot drain properly through the normal tear drainage system or when tear production is increased beyond normal levels. While epiphora itself is not typically serious, it can indicate underlying eye problems that require veterinary attention.

The tear film serves important functions in maintaining eye health, including lubricating the eye surface, providing nutrients to the cornea, and washing away debris and bacteria. When this delicate balance is disrupted, pets may experience persistent wetness around their eyes, leading to skin irritation, bacterial growth, and unsightly staining of the fur.

Epiphora affects various species of pets, with certain breeds being more predisposed due to their facial anatomy. Flat-faced (brachycephalic) breeds like Persian cats, Bulldogs, and Pugs are particularly susceptible due to their shortened tear drainage pathways and prominent eyes.

Causes

Epiphora can result from numerous underlying causes, which veterinarians typically categorize into two main groups: increased tear production and impaired tear drainage.

Increased Tear Production

When the eyes produce more tears than the drainage system can handle, overflow occurs. Common causes include:

Irritation and inflammation can stimulate excessive tear production. Foreign objects like dust, pollen, or small debris can irritate the eye surface. Chemical irritants, including household cleaners or grooming products, may also trigger increased tearing.

Infectious conditions such as conjunctivitis, caused by bacteria, viruses, or fungi, often lead to both inflammation and increased tear production. Upper respiratory infections in cats frequently involve the eyes and cause epiphora.

Allergic reactions to environmental allergens like pollen, dust mites, or certain foods can cause chronic eye irritation and excessive tearing.

Corneal problems including scratches, ulcers, or dystrophies cause pain and reflex tearing as the eye attempts to heal and protect itself.

Impaired Tear Drainage

Anatomical abnormalities are common in certain breeds. Shallow eye sockets, prominent eyes, and shortened nasolacrimal ducts can impair normal tear drainage. Eyelid abnormalities like entropion (inward rolling) or ectropion (outward rolling) can also disrupt normal tear flow.

Nasolacrimal duct obstruction can be congenital or acquired. The tiny ducts that normally drain tears from the eyes to the nose can become blocked by debris, inflammation, or scar tissue.

Facial structure plays a significant role, particularly in brachycephalic breeds where the compressed facial anatomy creates drainage challenges.

Symptoms & Signs

Early Signs

The most obvious early sign of epiphora is visible wetness around one or both eyes. Pet owners may notice their animal's face appears constantly damp or that they frequently paw at their eyes.

Tear staining often develops as a secondary sign, appearing as reddish-brown or dark streaks in the fur below the eyes. This staining is particularly noticeable in light-colored pets and results from iron compounds in tears oxidizing when exposed to air.

Mild eye discharge may accompany the excessive tearing, ranging from clear and watery to slightly thick and mucoid.

Advanced Symptoms

Skin irritation around the eyes may develop from constant moisture. The skin can become red, inflamed, and tender to touch.

Secondary bacterial infections can occur in the moist environment created by persistent tearing. This may lead to a foul odor and thicker, colored discharge.

Hair loss around the eyes may result from constant moisture and scratching.

Behavioral changes such as increased pawing at the face, head shaking, or reluctance to have the face touched may indicate discomfort.

Emergency Signs

While epiphora itself rarely constitutes an emergency, certain accompanying symptoms require immediate veterinary attention:

Sudden onset of severe tearing with eye pain, squinting, or cloudiness of the eye may indicate a serious corneal injury or acute glaucoma.

Thick, purulent discharge combined with swelling and severe redness suggests a serious infection requiring prompt treatment.

Changes in eye color or appearance of the pupil warrant immediate examination.

Diagnosis

Diagnosing epiphora requires a comprehensive eye examination to identify underlying causes. Your veterinarian will begin with a detailed history, asking about the duration of symptoms, any recent changes in environment or diet, and your pet's breed predispositions.

Physical examination includes careful inspection of the eyes, eyelids, and surrounding facial structures. The veterinarian will assess tear production, eye position, and eyelid conformation.

Fluorescein staining helps detect corneal scratches or ulcers that might not be visible to the naked eye. This safe dye highlights damaged areas of the cornea under special lighting.

Schirmer tear test measures tear production to determine if excessive production contributes to the problem.

Nasolacrimal duct flushing may be performed to check for blockages in the tear drainage system. This procedure involves gently flushing saline through the ducts to assess patency.

Bacterial culture might be recommended if infection is suspected, helping guide appropriate antibiotic selection.

Advanced imaging such as dacryocystorhinography may be necessary in complex cases to visualize the tear drainage system.

Treatment Options

Medical Management

Treatment depends on the underlying cause identified during diagnosis.

Topical antibiotics are prescribed when bacterial infection is present. Common options include erythromycin, gentamicin, or broad-spectrum combination antibiotics.

Anti-inflammatory medications like topical corticosteroids or non-steroidal anti-inflammatory drugs help reduce inflammation and associated tearing.

Antihistamines may be beneficial for pets with allergic epiphora.

Artificial tears can help maintain proper eye lubrication in cases where tear quality is poor despite adequate quantity.

Surgical Interventions

Surgical treatment may be necessary for anatomical problems causing epiphora.

Nasolacrimal duct surgery can address blockages that don't respond to flushing. This may involve creating new drainage pathways or removing obstructions.

Eyelid correction surgery addresses conformational problems like entropion or ectropion that interfere with normal tear drainage.

Conjunctivorhostomy creates an alternative drainage pathway when conventional tear ducts cannot be restored.

Ongoing Management

Many pets with epiphora require long-term management rather than a cure, particularly those with breed-related anatomical predispositions.

Home Care

Proper home care plays a crucial role in managing epiphora and preventing complications.

Daily cleaning of the eye area helps prevent bacterial growth and reduces staining. Use clean, damp cloths or veterinary-approved eye wipes to gently clean away tears and discharge.

Tear stain removal products specifically designed for pets can help minimize discoloration. Avoid products containing harsh chemicals or those not specifically formulated for animals.

Environmental management includes identifying and minimizing exposure to potential irritants like dust, smoke, or strong fragrances.

Proper grooming keeps hair away from the eyes, reducing irritation. Some pets benefit from having the hair around their eyes trimmed regularly.

Medication compliance is essential when veterinary treatments are prescribed. Follow dosing schedules carefully and complete full courses of antibiotics even if symptoms improve.

Prevention

While some causes of epiphora cannot be prevented, particularly those related to breed anatomy, several measures can reduce risk:

Regular eye examinations during routine veterinary visits help detect problems early.

Proper grooming prevents hair from irritating the eyes.

Environmental control minimizes exposure to dust, allergens, and irritants.

Prompt treatment of upper respiratory infections and other conditions that might affect the eyes.

Careful selection when choosing pets, considering breed predispositions to eye problems.

Prognosis & Recovery

The prognosis for pets with epiphora depends largely on the underlying cause. Cases related to temporary irritation or minor infections typically resolve completely with appropriate treatment. However, pets with anatomical predispositions may require lifelong management.

Infectious causes generally have excellent prognoses with proper antibiotic treatment, with most pets showing improvement within days to weeks.

Allergic epiphora can often be well-controlled with environmental management and appropriate medications.

Anatomical causes may require surgical correction for optimal results, though many pets live comfortably with conservative management.

Breed-related epiphora typically requires ongoing care but rarely impacts quality of life significantly when properly managed.

When to See a Vet

While mild epiphora may seem like a cosmetic concern, veterinary evaluation is important to rule out serious underlying conditions and prevent complications. Schedule an appointment if you notice persistent tearing lasting more than a few days, especially if accompanied by other symptoms.

Seek immediate veterinary care if your pet shows signs of eye pain, sudden changes in vision, thick or colored discharge, or if the eye appears cloudy or different in color. These signs may indicate serious conditions requiring prompt treatment to prevent permanent damage.

Regular veterinary examinations help monitor pets with chronic epiphora and adjust treatment plans as needed. Your veterinarian can provide specific guidance based on your pet's individual needs and underlying causes.