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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 them.
There are two types of tears. The first kind of tears are produced each time one blinks. These tears are released by glands on your eye lids.
The second type of tears are fluid substances that are released by a pair of almond-shaped lacrimal glands, one located in each eye in reactions to foreign substance, smells and emotion. These are reactive tear productions.
Tears are released onto the top surface of the eye by various lacrimal glands to form the aqueous layer that protects the cornea from harmful irritants.
However, excess tear formation can lead to watery eyes. Their functional purpose aside, watery eyes tend to turn your vision hazy, making it difficult for you to see properly.
Anyone who has had a good cry can attest to this fact, and the problem becomes almost a handicap if your eyes are constantly watering.
This form of excessive tear formation is medically known as epiphora, a common eye condition that plagues a large number of people worldwide.
People with watery eyes have a constant tear cover over their cornea, which makes their eyes look like they are made of glass.
Because there is an overproduction of tears that cannot be contained within the eyes, tears drip from the corners of the eyes without the affected person even realizing it.
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.
Although this form of ocular discomfort can occur at any age, it is most prevalent among:
- Children under the age of 2
- Adults above the age of 60
What Causes Watery Eyes?
Watery eyes are usually symptomatic of certain conditions, rather than a separate medical issue in itself. These conditions include:
- 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.
- 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.
- Weather Conditions: Sometimes, excess tear production occurs when you are exposed to cold or windy weather conditions.
- 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.
- Environmental Factors: Environmental chemicals present in the air or wind can irritate the cornea and cause your eyes to well up.
- Medications: Watery eyes can also be a side effect of certain medications such as epinephrine, eye drops, or drugs used in chemotherapy. (1)
- 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).
- Allergies: Allergies to dust, dander, or mold can render your lacrimal glands overly active, resulting in excessive tearing of the eyes.
- Light Sensitivity: Exposure to bright sunlight or indoor lights can make your eyes water.
- Eye Strain: 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.
- 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.
- 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.
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 even 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 a fluid to see if it drains properly through the canaliculus into the nose.
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:
- Eye Drops: If the excessive tearing is caused by dry eyes, you can use good-quality, lubricating eye drops to soothe the ocular surface.
Eye drops are generally available without a prescription, and there is a huge variety to choose from.
Your doctor can guide you toward the product that is most suitable for your case.
- Prescriptions eye drops: There are several products that your doctor will prescribe which will increase tear production in cases of severe dry eyes.
- Medication: If your eyes are watering due to an underlying eye infection, the doctor may prescribe a course of antibiotics to address the root problem.
If you develop watery eyes due to an allergy, antihistamines may be prescribed to curb the inflammatory response.
- Punctal plugs: Your doctor may block one or both of your punctum (drain).This will help retain the tears that your glands produce.
- Surgery: If a blocked tear duct is responsible for your excessively watery eyes, surgery may be recommended to create a new drainage outlet for your tears.
This type of surgery is known as dacryocystorhinostomy (DCR) and involves making a small incision under the inner corner of your eye, next to the nose.
The surgeon then cuts deeper into this skin incision to create a short passage through the nasal bone and sometimes insert a tube within it to keep it from getting congested in the future.
This new duct stretches from the lacrimal sac to your nasal cavity and facilitates easy drainage of the excess tears from your eyes.
Watery Eyes: Self-Care and Home Remedies
Watery eyes can be managed at home by following these self-care measures:
- Do not rub your eye: If you think there is something inside your eye, never rub it.
Rubbing your eye when you have a particle stuck in it may aggravate the discomfort and even lead to ocular damage.
- Observe good hand hygiene: Make sure to touch your eyes only with clean, sanitized hands.
- Use gentle heat therapy: If your eyes have turned extremely watery due to a blockage in the tear duct, placing a warm compress on the affected eye may help relieve some of the discomforts.
The mild heat may help relieve the congestion in the tear duct and facilitate the drainage of the excess tears.
- Wear contact lenses with caution: Make sure to remove your contact lenses before going to sleep and even before a short nap. It is best if you avoid wearing your contact lenses when swimming or showering.
- Cover your eyes with protective eyewear: Wear protective sunglasses to shield your eyes from airborne debris and particles when venturing outdoors, more so if the weather is particularly windy or cold.
Ask your optometrist to recommend appropriate eyewear for this purpose. Moreover, as watery eyes tend to be extra photosensitive, it is best to wear dark sunglasses to keep them comfortable in sunlight.
- Clean your eyewear: Make sure to wipe your sunglasses and spectacles before putting them on.
Wearing unclean eyewear can transfer the dust and other grime settled on it, to your eyes and face.
- Keep your eyewear and eye products for personal use only: To minimize the risk of eye infection, it is recommended to keep your eye makeup and other eye products restricted to personal use.
Sharing of eye products and eyewear is the easiest mode of spreading eye infections.
- Use a mild eye cleanser: Rose water works as a gentle eye tonic and has found great use in remedying a wide array of eye-related problems.
The efficacy of rose water in the prevention and treatment of ocular infections such as conjunctivitis can be attributed to its inherent analgesic and antiseptic properties. (4) (2)
- Frequently rinse your eyes: Although your eyes are self-cleaning organs that get washed by a steady secretion of tears, sometimes this natural mechanism may not suffice to keep your eyes clean and comfortable.
If you get something in your eyes that makes them tear up excessively, you can rinse them frequently with splashes of cool, clean water.
Wash your eyes thoroughly, but do not to rub them while doing so as it will only increase your irritation. This simple ocular hygiene measure helps clear any dust, pollen, or debris that may have found its way into your eyes.
Moreover, the overproduction of tears and ocular irritation caused by exposure to chemicals or harsh sun rays can be instantly reduced by splashing cold water on your eyes.
The following tips can help minimize the risk of contracting an eye infection and, thereby, save you from the discomfort of watery eyes:
- Prolonged exposure to the blue-light emission from LED screens can tire your eyes. You need to rest your eyes from time to time to prevent straining.
If your job or lifestyle requires you to extensively stare at a digital screen, you must make a conscious effort to break this pattern.
Distract yourself from the computer screen to relax your eyes at regular intervals. Electronic devices cannot be completely avoided but you must learn to use them judiciously.
Also, do not use these gadgets too close to bedtime as they can leave you invigorated and, consequently, disrupt your sleep. It is best to turn them off well in advance before you call it a night.
- When dealing with a child who has an ongoing eye infection, you must adhere to the doctor-stipulated standards of hygiene to prevent contaminating your own eyes.
This calls for proper hand sanitization, not just before treating the child’s eye but also once you are done administering the treatment.
Immediately discard any gauze or cotton balls that have been used in cleaning or medicating the child’s infected eye.
It is recommended to keep your child’s linens separate. Do not wash their used linens and towels along with the family’s laundry, as they can contaminate the entire stock.
Instead, wash them separately in hot water to weed out the infection.
The same holds true for an adult that has viral conjunctivitis as this infection can spread quite easily.
- People with dry eyes are advised not to use contact lenses as these can add to the ocular discomfort and make their condition worse.
The drier your eyes, the greater the tearing. (3)
- Replace your contact lens solution after every use. If you have recently recovered from an eye infection, it is all the more important to discard the solution used during the infection.
- If you use disposable lenses during an eye infection, you must throw them away once the condition clears.
Using a pair of contaminated lenses can bring back the infection.
- Make sure to clean your extended-wear lenses as directed by your eye specialist/optician/ophthalmologist.
Types of Tears
Our eyes produce two types of tears, each of which serves a distinctive purpose.
Basal tears are ever-present in your eyes to form a protective film over the cornea. These basal tears work as the first line of defense that shield your sensitive eye surface from incoming dirt and debris.
Besides providing a barrier between the eyes and the external elements, these tears are essential for moistening and nourishing your cornea.
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.
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 the above basic over the counter remedies for a period of 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.
- There is discharge or pain accompanying 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. This is a low-risk way to take care of watery eyes, though it doesn’t work for everyone.
Try either warm or cold compresses 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, you should 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, maybe the cause of the tearing eyes as well.
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. Of course, 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.
Additionally, 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 like tearing.
Overall, 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.
Blocked tear ducts are a common cause of tearing in adults and children. There can be many causes of blocked tear ducts, but fortunately, this is often correctable with surgical treatment.
In very young children, there are sometimes non-surgical alternatives, as it can be 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 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, you can try wearing eyeglasses or sunglasses to block the wind, or you can apply artificial tears to lubricate the surface before you go out in the cold.
Avoiding extended periods in cold weather is also an option, if at all possible.
In general, I recommend starting with low-risk treatments and slowly adding therapies if the first does not help.
For instance, warm or cold compresses on the eyes sometimes help patients, and this is a very low-risk treatment that is generally safe for the eyes. If this doesn’t work, you can use artificial tears in the eyes regularly to lubricate the eyes.
The next step for tearing that isn’t relieved by either warm/cold compresses, or artificial tears may be 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.
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, USA. He is currently in his ophthalmology training at Harvard Medical School in Boston, MA, USA.