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Tears are indispensable for keeping your eyes healthy. Tears not only help lubricate the eyes but are also responsible for cleaning and protecting them.
However, if your eyes produce more tears than they contain, the excess tears tend to drip from the corners of your eyes at all times. This excess tear formation is medically known as epiphora and can make your vision hazy.
Epiphora is generally an irritating but harmless condition that resolves on its own, but in some cases, it can also indicate an underlying eye condition or disease.
How Common Is It?
Although this form of ocular discomfort can occur at any age, it is most prevalent among:
- Infants
- Children under the age of 2
- Adults above the age of 60
Types of Tears
The eyes produce two types of tears, each with a distinctive function.
1. Basal tears
Basal tears are released by the glands on your eyelids every time you blink. They moisten and nourish the cornea and form a film over the sensitive eye surface to protect it.
2. Reflex tears
Reflex tears are secreted by the eyes’ lacrimal glands as a defensive response against environmental irritants that may disrupt the integrity of the cornea.
Your eyes become flooded with reflex tears to wash away the invading agent, such as foreign bodies that get lodged into your eyes or chemical irritants present in smoke and onion fumes.
The lacrimal glands go into overdrive when they pick up on the presence of such irritants, and they secrete a larger amount of reflex tears than basal tears, which leads to excessive tearing. These reflex tears are known to contain a heavy dose of antibodies to fight off pathogens.
Causes of Watery Eyes
Watery eyes are usually a symptom of certain conditions, rather than a medical issue in itself. These conditions include:
1. Blocked tear ducts
When your tear ducts become blocked due to infection and inflammation, the immediate result is an overproduction of tears that make your eyes watery.
2. Dry eyes
As dry eyes are increasingly prone to irritation, the natural response of the body is to produce excessive tears to lubricate the eyes and bring down the ocular discomfort. This overstimulation of the lacrimal glands often results in more tears than the eyes can hold, leading to watery eyes.
In addition, surgery such as cataract surgery or LASIK surgery can exacerbate or even cause dry eyes as well.
3. Weather conditions
Sometimes, excess tear production occurs when you are exposed to cold or windy weather conditions.
4. Foreign objects
Corneal abrasion or laceration caused by the entry of a foreign object into the eyes, eye injuries, burns, chemicals in the eye, ingrown eyelash, and exposure to dust can result in excessively watery eyes.
5. Environmental factors
Environmental chemicals present in the air or wind can irritate the cornea and cause your eyes to swell up.
6. Medications
Watery eyes can also be a side effect of certain medications, such as epinephrine, eye drops, or drugs used in chemotherapy. (1)
7. Medical conditions
Epiphora can also be the by-product of certain medical disorders, such as corneal ulcer, conjunctivitis, bacterial keratitis, chronic sinusitis, thyroid disorders, and blepharitis (swelling along the edge of the eyelid).
8. Allergies
Allergies to dust, dander, or mold can render your lacrimal glands very active, resulting in excessive tearing of the eyes.
9. Light sensitivity
Exposure to bright sunlight or indoor lights can make your eyes water.
10. Eyestrain
Staring at LED screens for prolonged hours, reading fine prints, wearing low-powered glasses or lenses, and lack of sleep can make your eyes increasingly heavy, fatigued, and prone to watering.
11. Ectropion
Ectropion refers to an ocular condition in which the lower eyelid droops and turns outward, pulling away from the eye globe.
Because the eyelid margin turns inside out, the inner surface of the eye becomes exposed, and tears fail to pass into the punctum located at the corner of the eyes. The pooling of tears due to ineffective drainage leads to excessive tearing.
12. Entropion
Entropion refers to the abnormal inversion or inward turning of the lower eyelid and eyelashes, which makes them brush against the cornea and conjunctiva. This constant friction can make your eyes extremely watery.
Symptoms of Watery Eyes
Watery eyes are usually accompanied by the following symptoms:
- Your eyes tend to become increasingly irritated and may even turn red.
- Your eyelids may become swollen.
- You may experience a burning sensation in the eyes.
- Your eyes may start to itch.
- You may break into frequent sneezing spells.
- Your eyes may become increasingly sensitive to light.
- Your eyes can be painful if the condition is brought on by some sort of ocular trauma or injury.
- Your eyes may feel extremely tired, heavy, and sore.
- Your vision may become blurry.
- You may also notice increased eye discharge.
Medical Treatment for Watery Eyes
The treatment for watery eyes depends upon the underlying cause. Most cases of excessive tearing are rather short-lived, but the condition can persist for a long time if it is triggered by allergic conjunctivitis.
The most commonly used treatment strategies to stop watery eyes include the following:
1. Eye drops
If the excessive tearing is caused by dry eyes, you can use any good-quality OTC eye drops to lubricate the ocular surface. In severe cases, your doctor may prescribe strongly medicated eye drops to increase tear production.
2. Medication
The doctor may prescribe antibiotics if an eye infection is detected and antihistamines if the condition is triggered by an allergy or inflammatory response.
3. Punctal plugs
Your doctor may block one or both of your punctum (drain). This will help retain the tears that your glands produce.
4. Surgery
If a blocked tear duct is responsible for your excessively watery eyes, dacryocystorhinostomy (DCR) may be recommended to create a new drainage outlet for your tears.
Diagnosing Watery Eyes
To determine the underlying cause behind excessive tearing, the doctor will first inquire about your medical history and then examine your eyes. Your doctor may refer you to an ophthalmologist for additional tests if the results of the preliminary examination are inconclusive.
The ophthalmologist will check for any blockages in the tear duct by inserting a small probe into the opening of the duct that is located at the inner corner of the eye, called the punctum, and sometimes deeper into the short drainage channel which it opens into, called the canaliculus.
The tears that form in your eyes pass through the canaliculus to reach the tear sac. The doctor may flush your eyes gently with fluid to see if it drains properly through the canaliculus into the nose.
When to See a Doctor
Excessive tearing of the eyes is rarely an emergency and usually gets better without any need for medical intervention. However, if the eyes continue to water despite trying basic OTC remedies for 4 weeks, seek medical opinion.
Medical assistance is also warranted if:
- The irritation or watering of your eyes occurs after chemicals got into your eyes.
- Discharge or pain accompanies the tearing.
- You experience severe eye pain.
- Your eyes show signs of bleeding.
- You injured your eye.
- Your vision is constantly blurry.
- You have a partial or complete loss of vision.
Expert Answers (Q&A)
Answered by Dr. Grayson W. Armstrong, MD, MPH (Ophthalmologist)
Both warm compresses and cold compresses can be helpful for watery eyes, and it is worth trying both to see what works best for you. These remedies are low-risk ways to take care of watery eyes, although it doesn’t work for everyone.
Try either a warm or cold compress for a few days to see if it helps, and then switch to the other if there is no relief. If there is still tearing despite these compresses, see your eye doctor.
Rhinitis is inflammation and swelling in the mucosa of the nose, and this is often associated with tearing eyes. The underlying cause of the rhinitis, such as allergies or irritation, may also be the cause of the tearing eyes.
Alternatively, rhinitis can sometimes physically block the tear ducts from draining as well as they should, which means that tears build up in the eyes and sometimes pour down the cheeks.
Watery eyes due to allergies can be very bothersome and are often accompanied by itching, redness, and irritation.
It is important to see an eye doctor to ensure that watery eyes and itchiness are from allergies and not from an infection or some other cause before you get around to treating them. Avoiding allergens is most helpful, but this isn’t always possible.
Antihistamine eye drops can be used to decrease allergic responses of the eyes and can help with tearing. Depending on where you live, these may be available with or without a prescription from your eye doctor.
Artificial tear drops can be useful in clearing away allergens from the eyes and reducing allergic symptoms. Oral antihistamines can also be useful in treating allergic eye symptoms, such as tearing.
Blocked tear ducts have many causes and are a common cause of tearing in adults and children. Fortunately, this condition is often correctable with surgical treatment.
In very young children, nonsurgical alternatives are available, as it is normal to be born with blocked tear ducts, which improve with time and special care.
An eye doctor should evaluate you or your child to decide which steps, including surgery, are necessary.
Cold weather commonly causes the eyes to tear up. When the cold air hits the eyes, the body wants to protect the surface from the damaging cold wind and lubricate the surface of the eye. Tearing is beneficial and helps the eye stay moist and safe in cold environments.
To minimize tearing in cold weather, try wearing eyeglasses or sunglasses to block the wind, or apply artificial tears to lubricate the eye surface before you go out in the cold.
Avoiding extended periods in cold weather is also an option, if at all possible.
About Dr. Grayson W. Armstrong, MD, MPH: Dr. Armstrong went to medical school at the Warren Alpert Medical School of Brown University in Providence, RI. He is currently in his ophthalmology training at Harvard Medical School in Boston, MA.
Final Word
Watery eyes can be caused by a number of different reasons, which is why you need a conclusive diagnosis to pin the root cause.
The doctor will then recommend the appropriate treatment. In most cases, the healing process begins with low-risk treatments like warm/cold compress and artificial tears, slowly adding therapies if these do not help.
The doctor may suggest an eyelid scrub using a mild shampoo or soap that is safe for the eyes, antihistamine eye drops, or something else. Consider seeing an eye doctor if the tearing persists, as you may need to be prescribed medications or undergo surgery to treat the underlying cause.
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