Epiphora in Cats

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Section: Overview

Epiphora is an abnormal overflow of tears down the face that results from either obstruction of tear drainage through the nasolacrimal (tear duct) system or overproduction of tears that overwhelms the normal drainage system. The overproduction of tears is most often a reflex, activated to expel irritating material from the surface of the eye or when significant irritation develops inside the eye. Although uncommon, epiphora may also result from overactive lacrimal (tear) glands and be unassociated with any source of irritation.

Normal cats may occasionally have minor tear overflow or minor eye discharge. However, excessive, chronic or recurrent bouts of epiphora suggest a problem may be present.

Tears are continuously produced on the eye in most animals. With each blink of the eyelids, tears are pushed along the outer aspect of the eyelids towards the nose.

A small hole called a puncta is present in both the upper and lower eyelid very close to the where the lids meet near the nose. Tears normally flow down these two drainage holes into a central collecting sac (lacrimal sac) that sits just under the skin below the eye. From this sac, a small tube or duct (nasolacrimal duct) carries the tears into the nose. In some animals the duct opens just inside the nostril. In other animals, the duct opens further back in the nose. The tears also help keep the nose and nostril moist.

While tears are typically colorless, they can dry to a dark red-brown-black crust, especially in the cat. Chronic tearing can also result in a brown to rust-colored staining of the hair around the eyes and face of animals. This is believed to be due to porphyrins or other pigment-like substances present in the tears.

Tears that spill over onto the face can also be irritating to the skin of the face. Moisture and bacterial build-up in that area aggravates this irritation.

Causes

Epiphora can be caused by numerous conditions. Some common causes of tear flow obstruction include:

Inefficient drainage of tears from partial closure of the drainage openings, increased kinking of the drainage duct in the nose, or wicking of tears onto hairs present in the crease where the eyelids meet. This condition is most common in the flat faced, long-haired breeds of cats, particularly the Persian and Himalayan breeds.

Abnormally small tear duct openings

Inflammation within or nearby the tear duct system

Tear duct scarring after severe conjunctivitis

A foreign body lodged within the tear duct (rare in cats)

Epiphora can also result when tear production increases due to irritation of the eye or stimulation of the tear glands. Common causes of epiphora in this group include:

Hair rubbing on the eye from deformities of the eyelids, eyelashes growing in an abnormal location (distichiasis), or hair growing in a direction that bring it close to the eye (trichiasis)

Inflammation of the eyelids themselves (blepharitis)

Conjunctivitis

Keratitis or inflammation of the cornea

Corneal ulcerations, abrasions, scratches, wounds

Foreign body on the surface of the eye or exposure to irritants, such as smoke, chemicals, and soaps

Glaucoma

Anterior uveitis, or inflammation of the iris and ciliary body

Irritation or stimulation of tear glands from topical eye medications

Irritation from suture material around the eye from a recent surgery

Infection or irritation around or under the eye or within the eye socket (orbit)

Tearing with eating, which is a rare form of stimulation of the tear glands

Some of the above disorders cause both obstruction of tear flow and stimulation of excessive tear production.

What to Watch For

Watery discharge from one or both eyes

Possible tear staining on face below the eye, near the nose

Accumulation of dried discharge on the edges of the eyelids

Ulceration and irritation of the skin below the eye, near the nose

Rubbing of the eyes or face

Redness of the conjunctiva

Dramatic color change or cloudiness to the surface or within the eye

Possible pain with increased blinking or squinting

Possible swelling of the eyelids or face around the eyelids

Possible reduction or loss of sight

Possible change in size of the pupil or eyeball

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