Watery Eyes (Epiphora): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; further:
    • Inspection (viewing).
      • Skin and mucous membranes
      • Eyes [mucous secretion, tired eyes, swollen eyelids, red eyes], furthermore inspection of eyelids:
        • Examination of the eyelids, the tear points and the area in the inner corners of the eyes.
        • Eyelid blink frequency (during speech (15 ± 13 blinks/minute) and reading (5 ± 4 blinks/minute); typically, patients with dry eye have reduced intervals between blinks from approximately 6 seconds to 2.6 seconds)
        • Eyelid position and closure:
          • Eyelid malposition? (e.g., ectropion/outward tilt of eyelid, usually lower eyelid, entropion/inward tilt of lower eyelid, usually lower eyelid).
          • Eyelid closure insufficiency? (eg, facial nerve palsy)
        • Lid margin: inflammation or dysfunction of the meibomian glands.
      • Nose [examination for obstruction/blockage; pus; secretions bleeding]
  • Ophthalmic examination: slit lamp microscopic examination shows in the case of conjunctivitis sicca (dry eyes) with reflex tears if necessary:
    • Skin redness and damage to the ocular surface with punctate epithelial defects (keratitis punctata superficialis); late stage or severe course: Connective tissue hardening and corneal complications.
    • If necessary, additional signs of a meibomian gland dysfunction (thickened eyelid margins and telangiectasia / macroscopically visible extensions of superficially located smallest blood vessels).

    For further examinations, see medical device diagnostics.

  • Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.