Epiphora Treatment (Watering Eyes)

Threshold

If epiphora fails to respond to conservative management such as warm compresses and ocular lubricants (as prescribed/purchased over the counter, or as per the ICB formulary) the patient may be referred to an Ophthalmology Consultant-led Service for review.

Adult patients should only be referred by clinicians for consideration of the following surgical procedures if one of the following is present:

• Nasolacrimal duct obstruction causing distension of the lacrimal sac e.g. a dacryocystocele which would be prone to recurrent infection.
• Constant daytime clear watering causing tears to run down the face and severe enough to impair vision on a daily basis, causing smearing on glasses.
• Symptoms of persistent clear watering plus 3 episodes of infection or sticky discharge within 12 months

Surgical Treatment of Epiphora:

• Dacryocystorhinostomy (restores the normal flow of tears through the tear ducts to the nose)
• Punctocanaliculoplasty (to widen the punctual opening and to improve the drainage of tears)

Children with Epiphora should continue to be referred as normal.

Please note – this policy does not include referral for entropion correction. Entropion correction is routinely funded and is covered in the NWICB Eyelid Surgery Clinical Threshold Policy.

Cases for Individual Funding Consideration (Patients who do not meet the policy criteria)

On a case to case basis, patients might be eligible for surgical intervention, in consideration of their exceptionality. The requesting clinician must provide information to support the case for being considered an exception, by submitting an individual funding request.