This
62-year-old man developed a left red eye with lacrimation the day after his
coronary artery bypass graft. He was referred to the eye clinic where he was
treated for infective conjunctivitis with topical chlormaphenicol. Despite
treatment, his red eye and lacrimation persisted. Culture and sensitivity of
the lacrimal swab was negative for bacteria and virus. At the 3 months
review, his red eye had improved but he still complained of lacrimation and
problem in opening his eye. Syringing of the left punctum was patent.

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a. What is the diagnosis?
b. How can you confirm the diagnosis?
c. How do you explain the initial presentation?