Vision Centre

Watery Eyes or Epiphora

Epiphora, or watery eyes, results from excessive tear production. This is usually caused by irritation of the eye such as inturned eyelashes or even an obstructed tear duct. If Epiphora is caused by ectropion (out turned eyelids) or entropion (in turned eyelids) surgical repair may be needed.

More detail...

Tears are constantly produced to keep the eye moist. Normal tears are a mixture of salt, protein and mucous. If the eye is irritated traumatic tears are produced which are watery to wash the eye of the irritant.

Sometimes people suffer from an abnormal overflow of tears and their eyes are frequently watery. This is called Epiphora. Epiphora can occur suddenly usually resulting from an irritant to the eye such as dust or from an allergy. This type of Epiphora can clear up quickly and without treatment.

Chronic Epiphora sufferers however, can even require surgery to fix their watery eyes. The problem occurs with the Lacrimal system in the eye. Tears flow into the eye through tiny tubes from the Lacrimal glands. Tears drain from the eyes through the Lacrimal drainage openings or Puncta. There is a punctal opening in the corner on both upper and lower lids. The Puncta drain the tears through tiny tubes into the Lacrimal sac (a small pouch beneath the corner of each eye) which is then emptied into the inside of the nose or to the back of the throat. One of the common causes of Epiphora is a blockage somewhere in the Lacrimal drainage system. A blockage can occur at any point of the lacrimal drainage system. Some babies can be born with a blockage or underdeveloped lacrimal system. Usually these children outgrow this condition but a small number may need minor surgery to remove the blockage. A blockage can also occur if the lacrimal system is scarred from an old injury or trauma.

Deformities of the eyelids can interfere with the drainage of tears. A punctum can become blocked from trauma, age or infection. With age the mucous membranes of the eyes can break down (commonly in middle-aged women) this can cause the body to over produce tears to counteract the dryness caused by the break down of the mucous membrane among many other causes.

As you can see, Epiphora can be caused by a wide range of disorders so diagnosis by an Ophthalmologist is necessary to ensure the best treatment is provided for your situation.
 
Most cases of Epiphora can be treated and diagnosed quickly. If the watery eye is caused by an eyelash in the eye then removal of the eyelash will usually resolve the Epiphora.

Allergies can be treated with medication or drops and bacterial infections can be treated with antibiotics, etc.

If there is a blockage of the lacrimal duct the Ophthalmologist may probe and syringe the duct to locate the blockage. A thin probe is inserted into the lacrimal duct and if it enters without resistance the blockage is probably further down the system. Saline (weak salt water) is then syringed into the duct which can help clear the blockage if it is minor. If the blockage cannot be cleared by probing and syringing a DCR or Dacryocystorhinostomy surgical procedure may need to be performed. The DCR will bypass the blockage by creating a new passage for tears. The operation can be done through a small cut on the outside of the nose or inside the nose using special instruments. To keep the new drainage duct open a silicone tube is inserted which is left in place during the healing process and removed later in a minor surgical procedure.