Assessing epiphora can be tricky because patients usually complain of DRYNESS.
This lady complained of dryness, yet at one minute and 5 minutes, the right eye shows retained tears, whilst the left side is clearing.
The trick here is to be judicious in how much fluorescein you instill…don’t overdo it, just enough. Use a well soaked fluorescein strip, shake of any excess fluid, and touch very gently one small portion of the tarsal plate.
Then wait…..time will reveal the epiphora!
Lavage comes after tear assessment.
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