Procedures for excessive tearing

Tears are produced in the lacrimal glands and oil glands, then flow over the eye, then into the lacrimal puncta, through the lacrimal canaliculi, the lacrimal sac, the nasolacrimal duct, and into the nose.

Inflammation or blockage at any of these sites may cause excessive tearing. Similarly, improper position of the eyelid against the eye, or improper pumping action by the eyelid muscles, may result in tearing. Paradoxically, a baseline dry eye state may result in reflex tearing. Any structure on the eye which happens to protrude will result in premature evaporation of the tears, resulting in discomfort and reflex tearing. Such conditions may include corneal epithelial basement membrane dystrophy, corneal nodules and conjunctivochalasis.

Dr. Clark performs several procedures for the correction of these causes of tearing, such as punctoplasty (enlargement of the lacrimal punta of the eyelid), eyelid malposition surgery, corneal resurfacing, corneal nodule removal and conjunctivoplasty.

Conjunctivochalasis is an extremely common, underdiagnosed and largely undertreated condition consisting of laxity of the conjunctiva (the clear membrane on the surface of the eye) which occurs with age, repeated allergy attacks, repeated infections, eye rubbing, etc.

Dr. Clark has been a local pioneer in the treatment of conjunctivochalasis, having brought a minimally invasive, quick, elegant form of conjunctivoplasty from Japan. This technique, as opposed to the complicated techniques involving excision of conjunctival tissue, transplantation of amniotic membranes, and tissue adhesives, is based simply on tightening of the stretched, redundant tissue with a radio-frequency probe. Dr. Clark has been performing this highly successful technique for ten years, and it is now just starting to be adopted by his other American colleagues.