Watery Eyes (Epiphora): Or something else? Differential Diagnosis

Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99).

  • Stenosis (narrowing) of the lacrimal duct.

Respiratory system (J00-J99)

  • Rhinitis allergica (RA) (synonyms: allergic rhinopathy; allergic rhinitis; pollen-related allergic rhinitis, hay fever, hay fever, or pollinosis) – symptomatic hypersensitivity reaction of the nose induced by IgE-mediated inflammation of the nasal mucosa (rhinitis) as a result of allergen exposure.

Eyes and eye appendages (H00-H59).

  • Allergic eye irritation due to e.g. perfumes.
  • Dacryocystitis – inflammation of the lacrimal sacs; clinical picture: pain, redness and the formation of edema in the affected region, as well as severe watering eyes and vasodilatation of the conjunctiva (conjunctiva).
  • Ectropion – acquired malposition of the eyelid with an outward rotation; most often it is the lower eyelid.
  • Conjunctivitis, acute (conjunctivitis) (infectious conjunctivitis; viral conjunctivitis/keratoconjunctivitis epidemica).
  • Conjunctivitis sicca (dry eye) → reflex tears, which are a reaction to dryness of the ocular surface.
  • Trichiasis – inward turning of the eyelashes.
  • Ulcus corneae – corneal ulcer of the eye, which can occur as a complication in the course of keratitis (inflammation of the cornea).

Endocrine, nutritional and metabolic diseases (E00-E90).

  • Diabetes mellitus – leads to dry eyes, which in turn give rise to reflex tears (i.e., reaction to dryness of the ocular surface)

Causes (external) of morbidity and mortality (V01-Y84).

  • Foreign body

Injuries, poisonings, and other consequences of external causes (S00-T98)

  • Foreign body

Medication

  • Medications that can lead to dry eye syndrome (keratoconjunctivitis sicca).

Environmental stress – intoxications (poisoning) (including the issue of dry eyes and consequently reflex tears).

  • Work on the computer screen (screen work)
  • Intensive television
  • Car fan
  • Ozone, e.g. from copiers and printers
  • Irritating chemicals
  • Dry indoor air due tooverheated rooms, underfloor heating, air conditioning.
  • Insufficient or incorrect lighting
  • Environmental pollution (e.g. dust).
  • Cigarette smoke

Further

  • Age: mostly women due to the age-related change in hormones during menopause → functional disturbance of lacrimal drainage.
  • Tears due to deep grief, severe pain