Epiphora refers to an eye condition in which tears overfow from the margin of the eyelid by not following the normal lacrimal passage. Aside from tearing, there is no redness, swelling or pain in the affected eye. The symptoms are often worse during windy weather, winter and early spring. Eye examination reveals the constant overfow of tears. The skin under the inner canthus becomes very moist and there may be an eversion of the lacrimal punctum and no excretion of mucus when applying pressure to the acupuncture point BL 1 ( jīng míng). An obstruction may or may not be identified upon washing the lacrimal passage, but no mucus excretion from the lacrimal punctum will occur. This condition is more common in winter and spring, occurs in one or both eyes and is ofen seen in those with a weak constitution.

Epiphora can be divided into chronic and acute types. The main cause is irritation and inflammation that causes obstruction of the normal drainage of tears. Other causes are malformation of the eyelid, sinus infection or trauma to the area. It is diagnosed by observing the eyelid as well as the clinical history of the symptoms. During the differential diagnosis, inquire if there has been any loss or change in vision, headaches, sinus congestion or nasal allergies, as well as joint aches and pains. The tears may be cultured for bacteria to check for infection.

Western medical treatment usually includes antibiotics, artifcial tears or topical antihistamines. Surgery may be required to repair the eyelid if there is ectropion or entropion.

In TCM, this disease is referred to as liú lèi zhèng (流泪症, lacrimation syndrome). It is usually caused by liver blood deficiency, a loose lacrimal orifice or external wind pathogen. It can also be caused by qi and blood defciency or liver and kidney defciency. Lacrimation is the result of these defciencies and the subsequent inability to control fuids.