title: Epiphora secondary to punctal apposition in the setting of Graves' orbitopathy.
abstract: The authors describe a patient who had epiphora and lacrimal outflow obstruction associated with proptosis and prolapse of orbital fat into the eyelids. The patient's puncta remained opposed throughout the blink cycle. A bilateral transcutaneous orbital fat decompression was done via upper eyelid crease and lower eyelid infraciliary incisions. Significant extraconal fat was removed. Two months after surgery, the epiphora had completely resolved, and proptosis and eyelid fullness had decreased.
authors.affiliation: Department of Ophthalmology, Albany Medical College, New York.
authors.forename: M M
authors.initials: MM
authors.lastname: Cheema
authors.forename: D R
authors.initials: DR
authors.lastname: Meyer
mesh_terms: D000273:Adipose Tissue / Q000473:pathology / Q000601:surgery; D005094:Exophthalmos / Q000150:complications / Q000473:pathology; D005141:Eyelid Diseases / Q000150:complications* / Q000601:surgery; D005143:Eyelids / Q000601:surgery; D006111:Graves Disease / Q000150:complications*; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000209:etiology*; D007767:Lacrimal Duct Obstruction / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000473:pathology / Q000601:surgery; D011391:Prolapse