‘Watery Eyes’ is the term used to describe the excess production of tears, which flow out of the eye and down the cheek. The condition is caused either by the overproduction of tears (lacrimation) or insufficient tear drainage (epiphora).
These problems can result from eye conditions such as conjunctivitis, an eye injury, blocked tear ducts, problems with the eyelids or irritation to the eyes. Anybody can get watering eyes at any age but it is more common in babies when they are 0-12 months old and in people over the age of 60. The condition can also affect either one or both of the eyes.
How Tears Work
Tears are continuously produced by the small lacrimal glands underneath the eyelid to keep the eyes lubricated. They are spread over the front of the eye with every blink and then pass into the tiny canaliculas channels before being drained away into the punta (tear sac) and then flowing into the nose via the tear ducts. A problem with this process is the primary cause of watery eyes.
Symptoms of Watery Eyes
The main symptom of watery eyes is the production of excess tears so, for example, the production of tears when you are not upset. The scale of the excess moisture can range from a small trickle down your cheek to many tears rolling down your face. It’s also common for people with the condition to experience more watering when outside in the cold or windy weather. Other symptoms of watery eyes include:
- A sticky feeling in the eye, besides mucus and/or crusting
- Swelling and discomfort at the inner corner of the eye near the bridge of the nose.
- Sore, red eyelid edges
Causes of Watering Eyes
Watering eyes are either caused by the excess production of tears or by a dysfunction with how tears are drained away. The production of too many tears is called lacrimation and insufficient tear drainage is called epiphora.
Several reasons could cause the excess production of tears:
- Irritation caused by chemicals, dirt or grit in the eye
- Entropian is caused when the edge of the eyelid and eyelashes turn inwards to rub against the surface of the eyeball.
- Blepharitis which is the inflammation of the edge of the eyelid, causing redness and soreness.
- Dry Eye (the syndrome were not enough tears are produced or tears aren’t lubricating the eye sufficiently) can cause the eyes to become sore and lead to the over-production of tears.
- Conjunctivitis is the inflammation of the conjunctiva (the transparent layer that lines the eyelids and covers the white of the eye) causing the eye to become sore and red.
- A scratch to the surface of the cornea (the transparent dome-like structure at the front of the eye) can cause excess watering.
- Inflammation of the iris (the coloured part of the eye) can cause watery eyes.
The eyes have a drainage system designed to remove excess tears. If this system is blocked or becomes dysfunctional, it can cause the eyes to produce excess moisture. The tear ducts can become blocked if they become inflamed or infected or as they deteriorate with age.
A blockage in the tear ducts can lead to dacryocystitis, the development of an infection which causes the corner of the eye nearest the nose to swell. Injuries to the eye can also cause scar tissue which block the tear ducts. Some babies are also born with blocked tear ducts, causing watery eyes.
Another possibility is to have a condition called ectropion. This is where the eyelid droops away from the eye, causing problems with tears draining away properly.
Diagnosis of Watery Eye
Your GP will talk to you about your symptoms and examine your eye. You may also be asked about your medical history. If there is evidence of discharge or pus coming from your eye then you GP may also take a swab to detect for any signs of infection.
Following examination, you may be referred to an ophthalmologist and he/she will arrange for further tests.
Treatment for Watering Eyes
The type of treatment recommended for you will depend on the cause of your watering eye. If your symptoms are very mild you may not require any treatment. And babies with blocked tear ducts may not need any treatment as the condition is likely to clear up within their first year.
Taking Extra Care
You can take extra care of your eyes and help to alleviate the symptoms of your watery eyes by keeping your eyes clean and clearing away any stickiness or crusting. You can ease your symptoms by compressing a warm, damp towel over your eyelid for a few minutes. If you are suffering with swelling in the eye then a cold compress is more suitable.
If you have a mild infection in the eye then your may be prescribed eye drops, ointment or antibiotic tablets. If dry eye syndrome is causing the excess tearing then artificial tears can help to keep the surface of your eye better lubricated and healthier.
This procedure opens up and clears away any narrowing of the tear duct openings in the eyelids. It involves local anaesthetic in the eye to completely block the pain. Patients stay awake during the procedure and a fine pencil-shaped instrument is used to open up the tear ducts.
If the blockage is deeper in the tear duct then lacrimal syringing can be used to help establish the position of the blockage. This procedure is also carried out under local anaesthetic. It usually involves the ophthalmologist adding yellow dye to the eye before syringing to help determine whether and where the ducts are blocked.
A thin metal tube, connected to a syringe of salt water, is then inserted into the tear duct. The salt water is washed through the duct to either determine the location of the blockage or remove it. During this part of the procedure, the patient can usually feel the salt in the nose or taste it in the mouth.
If all prior treatments are unsuccessful in unblocking the tear ducts then surgery is an option. Surgical procedures can help to unblock and/or widen the tear duct that opens in the nose. This operation is called a dacryocystorhinostomy (DCR) and can be undertaken under either local or general anaesthesia. X-rays of the eye are normally required before going ahead with the procedure, to establish the location of the blockage and whether surgery is likely to be successful.
A DCR procedure can be undertaken in one of two different ways. The surgeon may either insert special instruments up through the nose or make a cut into the skin at the side of the nose. Whichever method is used, the surgeon will make a small hole in the bone between the nose and the tear sac. Small tubes will be placed in the hole to ensure the hole stays open and heals properly and these tubes will be removed a few weeks later.
You may also be prescribed with eye drops and tablets to help prevent an infection following the operation.
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