Laryngorhinootologie 2020; 99(04): 247-261
DOI: 10.1055/a-1036-6738
Facharztwissen HNO
© Georg Thieme Verlag KG Stuttgart · New York

Erkrankungen des Tränenapparats, Teil 2: Grundlagen der Therapie

Disorders of the Lacrimal Apparatus, Part 2: Basics of Therapy
Jens Heichel
,
Hans-Gert Struck
,
Arne Viestenz
,
Alexander Glien
,
Stefan Plontke
Further Information

Publication History

Publication Date:
20 April 2020 (online)

Abstract

The tearing eye (epiphora) is deemed to be the leading symptome of efferent tear duct stenosis. Nevertheless, epiphora might be caused by ocular surface pathologies or even intraocular diseases. A distinguished anamnesis and sufficient clinical examination is most meaningful for the differential diagnostic distinction. Therapy is based on pathologic changes. In case of ocular surface disease, a suitable tear substitution and antiinflammatory approach is mandatory. Multifarious triggers have to be considered as well. Addressing tear film distribution, suitable oculoplastic surgery is required. Efferent tear duct stenosis necessitates surgical treatment as the level of suffering is often very high and acute exacerbations may develop. Besides recanalization, anastomosing techniques represent the available therapeutic principles. Possible surgical approaches offer a great variety and many influencing factors navigate therapy decisions. This part of the review comments on the most important therapeutic approaches for lacrimal apparatus diseases.

Erkrankungen des Tränenapparats gehen mit starken Beschwerden und einem hohen Leidensdruck der Patienten einher. Sie stören die Homöostase der Augenoberfläche und können zu schwersten Sehstörungen bis hin zum Visusverlust führen. Die Gliederung in Tränenproduktion, -verteilung und -abtransport muss auch bei der Therapieplanung Berücksichtigung finden.