objective assessment of epiphora
Author: TSUGIHISA SASAKI
Base Hospital / Institution: Sasaki Eye Clinic
ePoster presentation
Abstract ID: 25-325
Purpose
To evaluate objective methods for assessing epiphora.
Methods
We retrospectively analyzed 238 eyes of 147 patients (45 men, 102 women; mean age 69.4 ± 15.1 years, mean ± SD) who were treated or followed at our institution for epiphora between October 2024 and April 2025. Tear meniscus height (TMH) was measured using slit-lamp photography or anterior segment OCT (Nidek, RS-3000A). In addition, a macro-observation method using fluorescein dye and a UV-cut black light (macro method), and the Munk score (MS) assessed at the same time, were compared. In the macro method, tear overflow was graded as follows: Grade 3, overflow from both temporal and nasal conjunctival fornices or from the center; Grade 2, overflow from either side; Grade 1, barely no overflow; Grade 0, no epiphora.
Results
No ocular complications were observed with the use of the UV-cut black light. Among patients with severe lacrimal drainage disorders (MS ≥ Grade 4), the MS showed relatively good correlation with the macro method, while the correlation between MS and TMH was weak; some cases even showed lower TMH in the high MS group compared when tears overflowed from the conjunctival fornix. In patients with mild or no epiphora (MS < Grade 4), MS and TMH showed relatively good correlation. Interestingly, some patients with allergic conjunctivitis were classified as MS Grade 3 but showed no overflow using the macro method.
Conclusion
TMH measurement may be useful as an objective assessment tool for mild epiphora, while the macro method may be applicable for evaluating severe epiphora, as an alternative to the subjective Munk score.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Tomomi | Higashide | Kanazawa University Graduate School of Medical sciences |
