If you produce too much tears, or if there is something wrong with your eyes’ ability to drain them away, you will have water eyes. This can happen to anyone, but it is seen most often in newborn babies, as well as those who are more than 60 years old. People with watery eyes often complain of waking up with sticky eyes and sore eyelids, and they may also experience some blurring of their vision. If you have watery eyes and the problem persists, or if you experience any swelling or lumps, you need to seek medical attention.
The Causes of Watery Eyes
Most of the time, watery eyes are caused by a problem with your Meibomian glands. These glands, found in the eyelids, excrete the lipids (oils) necessary to slow down the tear evaporation. Meibomian gland dysfunction (MGD) can lead to some patches on your eye becoming dry. These patches can be quite painful and this will force the eyes to produce more tears, which is a reflex but doesn’t actually help.
There are some other possible causes, including:
- Ectropion, which means the bottom eyelid sags, making it very hard for the tears to get to the drainage duct
- Entropion, whereby your eyelids roll into the eye
- Blepharitis, an inflammation of the eyelids’ edges
- Problems with your tear ducts, such as narrowing or blockages
- Irritation as a result of grit or chemicals
- Conjunctivitis or other infections of the eyes
Diagnosis and Treatment
You will usually be sent to an ophthalmologist or other eye specialist for investigation if the cause is not clear. They will check whether your tear ducts are blocked. They do this by first applying anesthetic drops, before inserting a small probe into your drainage channels. They may also inject some fluid in your tear duct, which should come out through your nose.
They may also place a little bit of dye inside your eyes. If, after five minutes, a lot of dye is left, there will be reason to believe that there is a blockage. In this case, a scan may be prescribed, which is done by putting a few drops of dye in your eye before taking an x-ray. This will help the ophthalmologist identify where the blockage is.
Treatment depends on the reason for your extra tear production. If you suffer from dry eye syndrome (DES), then you will probably simply have to try artificial tears, which are drops that are available as an over the counter remedy. You will probably have to try a range of different brands before finding one that is right for you. If the cause is an infection or an allergy, you may have to try medication. In some cases of blockage, you will need surgery, although this is rare.
You also have the option of choosing not to have any treatment, particularly if you don’t feel the watering interferes with your quality of life.
There are also quite a few things that you can do in order to make the situation better yourself:
- If you suffer from DES, avoid watching television, reading, or using a screen for a while. We naturally blink less when we use our eyes for these things, and this can make you teary eyes worse.
- You can try over the counter lubricating eye drops. You will probably have to try a few different brands before you can decide which one is right for you. Try to avoid eye drops with preservatives, as these can irritate your eyes with prolonged use.
- Hold a warm compress over your eyes for a few minutes, using the cloth to massage your eyes. This will also help you to clear any debris that remains in your eyes.
If you do have to have some form of medical treatment, the exact medication will depend on the reason behind the irritation:
- Bacterial or viral conjunctivitis has to be treated with antibiotics or antiviral medications. If it is caused by a virus, you will usually be asked to see if it clears up on his own first.
- Allergic conjunctivitis or other allergic reactions can be treated with antihistamines, helping to lower the inflammation.
- An ingrowing eyelash can also cause your watery eyes, as can having a foreign object in your eye. This has to be removed by a medical professional.
- If you have entropion or ectropion (where your eyelids roll inwards or outwards), you may need a minor operation. This is completed under local anesthetic, during which your tendon will be tightened.
- If you have a blocked tear duct, you may need surgery to remove the blockage.
- If your tear sac is infected, you will first be given a course of antibiotics, followed by surgery. This should not be left untreated, as it can spread and effect the socket of your eye.
Types of Surgical Operations
A number of different operations can be carried out on your eyes if the underlying cause of your teary eyes requires it.
- Dacryocystorhinostomy (DCR)
DCR is a type of surgery used if you have a blocked tear duct. The procedure means that a physician will create a new channel that leads from the tear duct, effectively bypassing the blocked part of your tear duct. A small piece of bone will be taken out of the side of your nose, so that your tears drain straight into your nasal cavity. Only a small incision has to be made, and the procedure is completed using an endoscope. Hence, a local anesthetic is usually all that is required, although some physicians prefer to use a general anesthetic. The entire procedure takes about an hour to complete. It is also possible for a small balloon, which is a type of catheter, to be inserted in the tear duct in order to widen it, which avoids the need to remove bone. It is very important that you follow the aftercare procedures prescribed to you by your physician, which usually includes using a nasal spray and prescription eye drops. Some swelling, tenderness, and nose bleeds are common for a few days.
- Lester Jones Procedure
The Lester Jones procedure is offered if the canaliculi, which are the eyes’ internal drainage channels, are completely blocked due to an accumulation of tears. The procedure involves inserting a Lester Jones Tube, which is usually made of glass, inside the canaliculi. This enables the tears to drain away.
Watery Eyes in Babies
It is very common for babies to have watery eyes and treatment is almost never required. At home treatment includes massaging the tear ducts gently, thereby dislodging the tears. Remember to always have clean hands when you do this, and to be very gentle. You can try this a few times per day, and you may have to keep it up for a few months. Alternatively, try a warm compress on your baby’s eyes. Do make sure that the water is lukewarm or slightly cooler so as not to injure your baby’s delicate skin and eyes with heat. If the tears turn into a yellow discharge, your baby may have conjunctivitis, which may need treatment.
Ninety percent of the time, the blocked tear duct will open up by itself before your baby reaches one. However, if you have a one year old who continues to have infections as a result of blocked tear ducts, a doctor may use a probe to open the duct. This is completed under a general anesthetic. This treatment is very rare, but it does happen. In the rarest of cases, DCR may be required.
Resources and References:
The safety and efficacy of silicone tube for the management of watering eye – Study on the use of silicone tube to manage watering eye. (World Health Organization)
Watery Eyes – Information on the symptoms of watery eyes. (Medicine Net)
Watering Eyes (Epiphora): Causes, Symptoms, Treatments – Information on the symptoms of, causes of, and treatment for watery eyes. (Medical News Today)
Watering Eyes (Epiphora) – Information on watery eyes. (Patient Info)