title: Epiphora: an evidence based approach to the 12 minute consultation.
abstract: BACKGROUND
  Epiphora is the presence of a watering eye which may be due to reflex tearing or defective drainage of tears. Whilst most cases present to the ophthalmologist the otolaryngologist has a key role to play in both assessment and management of these patients.
  
  
  METHODS
  This review was based on a literature search last performed on 21st October 2009. MEDLINE and Cochrane databases were searched using the subject headings 'epiphora' or 'functional epiphora' in combination with diagnosis, investigation, management, treatment, intervention and surgery. Results were limited to English language articles. The personal biographies of the senior authors were also used.
  
  
  CONCLUSIONS
  An accurate assessment of the site and degree of obstruction is important to ensure the correct management is undertaken. Medical treatment with nasal steroid spray may be effective but the majority of obstructed cases will require surgical intervention in the form of dacryocystorhinostomy (DCR). There is increasing evidence that powered endoscopic DCR has outcomes comparable with the 'gold standard' procedure of external DCR.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Cumberland Infirmary, Carlisle, UK. kblackmore@nhs.net
authors.forename: K J
authors.initials: KJ
authors.lastname: Blackmore
authors.forename: G
authors.initials: G
authors.lastname: Ainsworth
authors.forename: A K
authors.initials: AK
authors.lastname: Robson
mesh_terms: D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000175:diagnosis*; D009885:Ophthalmology / Q000379:methods*; D010036:Otolaryngology / Q000379:methods*; D011379:Prognosis; D012017:Referral and Consultation; D013997:Time Factors