Abstract
Functional obstructions of lacrimal drainage systems are an under diagnosed entity. Epiphora in the presence of a patent lacrimal pathway and absence of alternative etiology could be the simplest description. Nomenclature has been confusing since functional issues of lacrimal system have been poorly defined. The current chapter describes the clinical examinations, investigations, management, and outcomes of functional epiphora.
References
Chan W, Malhotra R, Kakizaki H, et al. Perspective: what does the term functional mean in the context of epiphora? Clin Experiment Ophthalmol. 2012;40:749–54.
Domerest BH, Milder B. Dacryocystography. The pathologic lacrimal apparatus. AMA Arch Ophthalmol. 1955;54:410–21.
Montanara A, Ciabattoni P, Rizzo P. Stenoses and functional disorders of the lacrimal drainage apparatus. Radiological examination. Surv Ophthalmol. 1979;23:249–58.
Moscato EE, Dolmetsch AM, Silkiss RZ, Seiff SR. Silicone intubation for the treatment of epiphora in adults with presumed functional nasolacrimal duct obstruction. Ophthal Plast Reconstr Surg. 2012;28:35–9.
Conway ST. Evaluation and management of “functional” nasolacrimal blockage: results of a survey of the American society of ophthalmic plastic and reconstructive surgery. Ophthal Plast Reconstr Surg. 1994;10:185–7.
Hurwitz JJ, Welham RAN. Radiography in functional lacrimal testing. Br J Ophthalmol. 1975;59:323–31.
Cheung LM, Francis IC, Stapleton F, et al. Symptoms assessment in patients with functional and primary acquired nasolacrimal duct obstruction before and after a successful dacryocystorhinostomy surgery: a prospective study. Br J Ophthalmol. 2007;91:1671–4.
Jones LT. Epiphora. II. Its relation to the anatomic structures and surgery of the medial canthal region. Am J Ophthalmol. 1957;43:203–12.
Worst JGF. In: Veirs ER, editor. The lacrimal system. St Louis: Mosby; 1971. p. 98.
McNeill EJ, Kubba H, Bearn MA, et al. The management of rhinitis in patients with functional epiphora: a randomized controlled crossover trial. Am J Rhinol. 2005;19:588–90.
Kashkouli MB, Mirzajani H, Jamshidian-Tehrani M, et al. Reliability of fluorescein dye disappearance test in assessment of adults with nasolacrimal duct obstruction. Ophthal Plast Reconstr Surg. 2013;29:167–9.
Cuthbertson FM, Webber S. Assessment of functional nasolacrimal duct obstruction–a survey of ophthalmologists in the southwest. Eye (Lond). 2004;18:20–3.
Chung YA, Yoo IR, Oum JS, et al. The clinical value of dacryoscintigraphy in the selection of surgical approach for patients with functional lacrimal duct obstruction. Ann Nucl Med. 2005;19:479–83.
Wearne MJ, Pitts J, Frank J, et al. Comparison of dacryocystography and lacrimal scintigraphy in the diagnosis of functional nasolacrimal duct obstruction. Br J Ophthalmol. 1999;83:1032–5.
Francis IC, Chan DG, Papalkar D, et al. Videoreflective dacryomeniscometry in normal adults and in patients with functional or primary acquired nasolacrimal duct obstruction. Am J Ophthalmol. 2005;139:493–7.
Athanasiov PA, Madge S, Kakizaki H, et al. A review of bypass tubes for proximal lacrimal drainage obstruction. Surv Ophthalmol. 2011;56:252–66.
Peter NM, Pearson AR. External dacryocystorhinostomy for the treatment of epiphora in patients with patent but non-functioning lacrimal systems. Br J Ophthalmol. 2010;94:233–5.
Fulcher T, O’Connor M, Moriarty P. Nasolacrimal intubation in adults. Br J Ophthalmol. 1998;82:1039–41.
Connell PP, Fulcher TP, Chacko E, et al. Long term follow up of nasolacrimal intubation in adults. Br J Ophthalmol. 2006;90:435–6.
Tucker SM, Linberg JV. Measurement of the resistance to fluid flow. Ophthalmology. 1995;102:1639–45.
Demirci H, Elner VM. Double silicone intubation for management of partial lacrimal system obstruction. Ophthalmology. 2008;115:383–5.
Wormald PJ, Tsirbas A. Investigation and endoscopic treatment for functional and anatomical obstruction of the nasolacrimal duct system. Clin Otolaryngol Allied Sci. 2004;29:352–6.
Sahlin S, Rose GE. Lacrimal drainage capacity and symptomatic improvement after dacryocystorhinostomy in adult presenting with patent lacrimal drainage systems. Orbit. 2001;20:173–9.
Brewis C, Yung M, Merkonidis C, et al. Endoscopic dacryocystorhinostomy in functional lacrimal obstruction. J Laryngol Otol. 2008;122:921–3.
O’Donnell B, Shah R. Dacryocystorhinostomy for epiphora in the presence of a patent lacrimal system. Clin Experiment Ophthalmol. 2001;29:27–9.
Delaney YM, Khooshabeh R. External dacryocystorhinostomy for treatment of acquired partial nasolacrimal duct obstruction in adults. Br J Ophthalmol. 2002;86:533–5.
Cho WK, Paik JS, Yang SW. Surgical success rate comparison in functional nasolacrimal duct obstruction: simple lacrimal stent versus endoscopic versus external dacryocystorhinostomy. Eur Arch Otorhinolaryngol. 2013;270:535–40.
Jones LT. Practical fundamental anatomy and physiology of the eye. Trans Am Acad Ophthalmol Otolaryngol. 1958;62:669–78.
Murube del Castillo J. On gravity as one of the impelling forces of lacrimal flow. Japan: Ashavi Evening News; 1978. p. 51–9.
Hurwitz JJ, Maisey MN, Welham RAN. Quantitative lacrimal scintillography. Method and physiological application. Br J Ophthalmol. 1975;59:308–12.
Beigi B, Gupta D, Luo YH, et al. Punctal function in lacrimal drainage: the pipette sign and functional ectropion. Clin Exp Optom. 2015;98:366–9.
Tong NX, Zhao YY, Jin XM. Use of Crawford intubation for symptomatic epiphora without nasolacrimal duct obstruction. Int J Ophthalmol. 2016;9:282–5.
Shams PN, Chen PG, Wormald PJ, et al. Management of functional epiphora in patients with an anatomically patent dacryocystorhinostomy. JAMA Ophthalmol. 2014;132:1127–32.
Simsek I, Kiziloglu OY, Ziylan S. External dacryocystorhinostomy for the treatment of functional nasolacrimal duct obstruction. Turk J Ophthalmol. 2015;45:208–12.
Salour H, Khosravifard K, Bagheri A, et al. Efficacy of tightening of orbicularis muscle in patients with functional nasolacrimal duct obstruction. Orbit. 2016;35:11–5.
Stemplewitz B, Amin S, Emmerich KH, et al. Minimally invasive lacrimal duct surgery with a multimodal concept for functional lacrimal stenosis. Klin Monatsbl Augenheilkd. 2015;232:44–50.
Kamal S, Ali MJ, Gupta A, et al. Lacrimal and nasal masquerades of congenital nasolacrimal duct obstructions: etiology, management and outcomes. Int Ophthalmol. 2015;35:807–10.
Thale A, Paulsen F, Rochels R, et al. Functional anatomy of the human efferent tear ducts: a new theory of tear outflow mechanism. Graefes Arch Clin Exp Ophthalmol. 1998;236:674–8.
Ayub A, Thale AB, Hedderick J, et al. The cavernous bodies of the human efferent tear ducts contributes to regulation of tear outflow. Invest Ophthalmol Vis Sci. 2003;44:4900–7.
Paulsen F, Hallmann U, Paulsen J, et al. Innervation of the cavernous body of the human efferent tear ducts. J Anat. 2000;197:177–87.
Paulsen FP, Berry MS. Mucins and TFF peptides of the tear film and lacrimal apparatus. Prog Histochem Cytochem. 2006;41:1–53.
Park J, Kim J, Kim M, et al. Aquaporin expression in the lacrimal sac of patients with primary and functional nasolacrimal duct obstruction. Br J Ophthalmol. 2016;101(4):519–24. (Epub)
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Ali, M.J. (2018). Functional Obstructions of the Lacrimal System. In: Ali, M. (eds) Principles and Practice of Lacrimal Surgery. Springer, Singapore. https://doi.org/10.1007/978-981-10-5442-6_16
Download citation
DOI: https://doi.org/10.1007/978-981-10-5442-6_16
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-10-5441-9
Online ISBN: 978-981-10-5442-6
eBook Packages: MedicineMedicine (R0)