The Ophthalmology Unit,  Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.

The Ophthalmology Department, Sarawak General Hospital, Kuching, Sarawak, East Malaysia.

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Post-traumatic epiphora

Photo by Professor Chua Chung Nen

This 43 year-old man was referred from another town because of epiphora. He sustained a right facial injury 2 years ago in a road traffic accident but received no treatment. The referring doctor taught the ectropion to be the cause of the epiphora. However, examination revealed dehiscence of the right lateral canthus from the lateral orbital rim, right enophthalmos and loss of the cheek prominence. All these features were suggestive of orbital fracture. In addition, syringing of the lower punctum resulted in regurgitation of purulent discharge from the upper punctum. A CT scan was ordered to delineate the orbital bony structure.

It is likely that this patient requires resetting of the orbital bone(s), dacryocystorhinostomy and ectropion correction.

 

Right lower lid ectropion and enophthalmos.

 

Loss of the right cheek prominence.

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