Illacrimation or epiphora may be due to hypersecretion from the lacrimal gland. However, it is more often caused by obstructed drainage through the lower lacrimal system.

Causes of hypersecretion:

❖ Emotional distress (crying).

❖ Increased irritation of the eyes (by smoke, dust, foreign bodies, injury, or intraocular inflammation) leads to excessive lacrimation in the context of the defensive triad of blepharospasm, photosensitivity, and epiphora.

Causes of obstructed drainage:

❖ Stricture or stenosis in the lower lacrimal system.

❖ Eyelid deformity (eversion of the punctum lacrimale, ectropion, or entropion).

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