Obstruction of the lower system (usually of the nasolacrimal duct ... can contribute to punctal stenosis. Conjunctivochalasis is an under-recognized cause of upper lacrimal system epiphora.

The term functional nasolacrimal duct obstruction (FNLDO; watering with patent drainage) is misleading as it implies occluded drainage and solely nasolacrimal duct pathology. 'Normal' tear ...