H04.213 Epiphora due to excess lacrimation, bilateral lacrimal glands

Name of the Condition

• Epiphora due to excess lacrimation, bilateral lacrimal glands

Summary

Epiphora due to excess lacrimation, bilateral lacrimal glands, is a condition characterized by excessive tearing from both eyes, specifically resulting from overproduction of tears by the lacrimal glands. This differs from epiphora caused by drainage issues, as the primary problem lies in increased tear production from the glands themselves.

Causes

Common causes include inflammation or irritation of the bilateral lacrimal glands, which can stimulate excess tear production. Other triggers may include ocular surface disorders, certain medications, or systemic conditions affecting tear secretion. Environmental factors like wind or smoke may exacerbate symptoms but are not primary causes.

Risk Factors

Risk factors include chronic eye inflammation, exposure to irritants, or underlying conditions that affect lacrimal gland function. Age-related changes or anatomical factors specific to the bilateral lacrimal glands may also contribute to increased lacrimation.

Symptoms

Typical symptoms include persistent watery discharge from both eyes, tears rolling down the cheeks, and possible irritation or redness around the eyes. Symptoms may worsen with environmental triggers or prolonged eye use.

Diagnosis

Diagnosis typically involves a physical examination, history evaluation, and assessment of tear production and drainage. Tests like the Schirmer test may measure tear production, while dye disappearance tests or imaging can rule out drainage abnormalities. Evaluation of both lacrimal glands is essential to confirm bilateral involvement.

Treatment Options

Treatment focuses on addressing the underlying cause of excess lacrimation. Options may include anti-inflammatory medications, lubricating eye drops, or management of systemic conditions. In some cases, procedures to reduce tear production or address glandular issues may be considered.

Prognosis and Follow-Up

Prognosis depends on the underlying cause and response to treatment. Regular follow-up may be necessary to monitor symptoms and adjust therapy. Early intervention can help prevent complications like skin irritation or secondary infections.

Complications

Potential complications include chronic skin irritation around the eyes, blurred vision from excessive tearing, or secondary infections due to prolonged moisture. Persistent symptoms may also impact quality of life.

Lifestyle & Prevention

Avoiding irritants like smoke or dust, using protective eyewear in windy conditions, and managing allergies can help reduce symptoms. Maintaining good eye hygiene and avoiding rubbing the eyes may also be beneficial.

When to Seek Professional Help

Seek medical attention if symptoms worsen, persist despite home care, or are accompanied by pain, redness, or vision changes. Prompt evaluation is important to rule out serious underlying conditions.

Tips for Medical Coders

Document the bilateral nature of the condition and confirm that excess lacrimation is the primary cause, not a drainage issue. Ensure clinical notes specify involvement of both lacrimal glands to support accurate coding.