Is it normal to cry as you get older?

Many people have this experience in life: when going out or running on a windy day, tears always flow out of the corners of the eyes involuntarily. They are in a good mood, but they cry for no reason, especially when the wind is cold. Many people become particularly "crybaby" when they reach middle age. Tears always fall uncontrollably, and even when you gently squeeze the corners of your eyes with your fingers, yellow-white pus will overflow. Zhang Jiang, director of the National Ophthalmic Endoscopic Diagnosis and Treatment Technology Evaluation Committee, deputy chief physician, and director of the tear duct/eye and nose related department of the Aier Eye Hospital affiliated to Wuhan University, reminded that this is not because of sadness, but a typical symptom of tear duct disease.

01. Simple self-test for tear duct diseases

Tear duct diseases are common diseases in ophthalmology, mainly manifested by blockage or stenosis of various parts of the tear duct, functional epiphora, acute and chronic dacryocystitis, or tear duct diseases caused by congenital factors, which are more common in the elderly and infants.

Patients with tear duct disease can make a simple judgment based on the symptoms: if the only symptom is tearing, the patient may have tear duct obstruction or stenosis. If in addition to tearing, it is accompanied by itchy eyes, redness and swelling in the corners of the eyes, and pus flows out of the corners of the eyes when lightly squeezing, then it may be dacryocystitis.

02. The “time bomb” next to the eyeball

People over 50 are prone to tear duct diseases. Although the incidence rate is high, middle-aged and elderly people are very likely to ignore the harm of tear duct diseases and delay treatment. If the tear duct is blocked for a long time and not treated in time, it will cause lacrimal sac inflammation and cause pus in the corner of the eye. The purulent secretions in the corner of the eye contain a large number of bacteria. If they overflow and infect the eyeball, bacterial keratitis is likely to occur. In severe cases, it may also cause corneal ulcers and even the risk of perforation and blindness.

Because chronic dacryocystitis poses many threats to the eyeball, ophthalmologists often compare chronic dacryocystitis to a "time bomb" next to the eyeball. This is because when performing intraocular surgery such as cataract surgery, dacryocystitis must be cured first.

Daddy has cataracts and is nearly blind

But the doctor "stopped" me from having this surgery first.

Mr. Fang, who wanted to go to the hospital for cataract surgery recently, was "stopped" by the doctor and had to undergo tear duct surgery first.

Grandpa Fang, 72 years old this year, lives in Qingshan. He is in good health and likes fishing and reading. Two years ago, Grandpa Fang found that he could not see things clearly. He could not see the float clearly when fishing, and in the past month he could not see the newspaper clearly with a magnifying glass. After a check-up at the community hospital, it was found that he had cataracts, so Grandpa Fang came to the Aier Eye Hospital affiliated to Wuhan University to prepare for cataract surgery. But the doctor told him that because he suffered from chronic dacryocystitis, he needed to treat the dacryocystitis before he could have cataract surgery. If the operation was forced, the inflammation of the lacrimal sac would spread to the eye, which would have an adverse effect on the cataract surgery.

"Chronic dacryocystitis is a common eye disease caused by obstruction or stenosis of the nasolacrimal duct and is more common in women and the elderly." Zhang Jiang, director of the National Ophthalmic Endoscopic Diagnosis and Treatment Technology Evaluation Committee and director of the lacrimal duct/eye and nose related specialty, introduced that if chronic dacryocystitis is not treated for a long time, it will lead to keratoconjunctivitis, eyelid eczema, and will also lead to the inability to treat intraocular surgeries such as cataracts and glaucoma in a timely manner.

Taking into account Mr. Fang's physical and eye examination results, Zhang Jiang prescribed an endoscopic internal nasal lacrimal cystostomy for him. Unlike the traditional external nasal lacrimal cystostomy through skin incision, this procedure does not require an incision on the face to prevent facial scars, and does not require cutting the medial canthal ligament during the operation, resulting in less damage to the lacrimal sac, preserving the normal physiological function of the lacrimal sac and making the discharge of tears closer to physiology.

"Thanks to Director Zhang, my tear duct is finally unblocked, and now I can have cataract surgery without any worries." Yesterday, Mr. Fang, who came to the hospital for a follow-up examination, expressed his gratitude. Zhang Jiang said that since chronic dacryocystitis does not cause redness, swelling, pain or other discomfort, it is easy to be ignored. He reminded that citizens who have long-term tearing must go to a specialist clinic for examination and treatment, and if purulent secretions appear, they should see a doctor as soon as possible to avoid delaying the disease.

03. How to treat tear duct disease

At present, drug treatment alone cannot solve the problem well. Antibiotic eye drops have little effect because the tear duct is blocked by secretions and the eye drops cannot enter the tear sac. Therefore, surgery is the best way to cure tear duct disease.

Based on many years of clinical experience, the tear duct/eye and nose related specialists at the Aier Eye Hospital affiliated to Wuhan University have developed personalized full-system treatment plans for the treatment of tear duct diseases in accordance with the different needs of patients, helping more patients get rid of the problem of tearing.