Lapis ISSN 2398-2969

Eye: epiphora

Synonym(s): Tear overflow

Contributor(s): Natasha Mitchell, Tim Knott, Vladimir Jekl

Introduction

  • Overflow of tears (epiphora) is a common presentation in the rabbit and may be the first observed sign in many different ocular diseases or dental disease.
  • Early identification of the underlying cause is key.
  • Cause:
    • May be caused by increased tear production by impairment of the tear outflow (abnormal drainage of tears due to partial or total nasolacrimal duct obstruction, or due to lacrimal punctum stricture.

Not all runny eyes are caused by dacryocystitis.

Partial nasolacrimal duct obstruction is very common.
  • Epiphora is commonly associated with extramural nasolacrimal duct partial or total obstruction associated with maxillary incisor apical elongation.
  • Due to resulting thinning of the duct lumen, lipid drops and ocular debris can obstruct the duct readily.
  • Signs: wetting of periobital hair, usually ventromedial to medial canthus. In more severe cases alopecia is present.
  • Diagnosis: clinical examination, skull radiography, nasolacrimal duct contrast radiography (dacryocystorhinography).
  • Treatment: identification and treatment of underlying cause.
  • Prognosis: dependent on underlying cause.

Presenting signs

  • Wetting or matting of periorbital hair.
  • Discoloration of hair and skin "tear staining" due to bacterial pigment.
  • Alopecia and/or superficial dermatitis of skin adjacent and beneath the medial canthus may be seen.
  • In case of conjunctivitis, signs of corneal/conjunctival inflammation and belpharospasmus may be seen.

Acute presentation

  • Facial wetting.

Geographic incidence

  • Worldwide.

Age predisposition

  • All ages.
  • Nasolacrimal duct obstruction is seen more commonly in older animals.

Breed predisposition

  • Can be more commonly seen in hairy rabbit breeds; corneal irritation by hairs touching the cornea.

Public health considerations

  • Periocular alopecia, crusting and epiphora may be present also in case of dermatophytosis, which is commonly zoonotic.

Cost considerations

  • Dependent on underlying cause.
  • Dacryocystitis Eye: dacryocystitisis a common cause - the use of radiography Radiography: dental, including computed tomography Computed tomography, may be indicated; prolonged treatment is often required.
  • In case of odontogenic abscesses , advanced surgeries are often needed.
  • Entropion Eyelid: entropion requires surgical correction under general anesthetic.

Special risks, eg anesthetic

Pathogenesis

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Diagnosis

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Prevention

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Bedard K M (2019) Ocular surface disease of rabbits. Vet Clin North Am Exot Anim Pract 22 (1), 1-14 PubMed.
  • Zhao J, Xu Z, Han A et al (2018) A huge lacrimal gland ductule dacryolith with a hairy nucleus: a case report. BMC Ophthalmol 18 (1), 244 PubMed.
  • Whittaker A L & Williams D L (2015) Evaluation of lacrimation characteristics in clinically normal New Zealand White rabbits by using the Schirmer Tear Test I. J Am Assoc Lab Anim Sci 54 (6), 783-787 PubMed.

Other sources of information

  • Jekl V (2018) Radiography in Pet Rabbits, Ferrets and Rodents. In: Practical Veterinary Radiography. Eds: Niemec B A, Gawor J & Jekl V. CCR Press, USA. pp 271-346.
  • Varga M (2014) Ophthalmic Diseases. In: Textbook of Rabbit Medicine. 2nd edn. Butterworth Heinemann Elsevier, USA. pp 350-366.
  • Williams D (2012) The Rabbit Eye. In: Ophthalmology of Exotic Pets. Ed: William D. Blackwell Publishing, UK. pp 15-55.


ADDED