Watery Eyes (Epiphora): Causes & Treatment

Watery eyes can result from one or both eyes producing too many tears, or the eyes having difficulty draining tears. Epiphora is the technical term for watery eyes. 

If your eyes feel too moist, you may notice excessive tears, blurry vision, or tears rolling out of your eyes. This can affect your overall quality of life as it can be difficult to see clearly.

This condition is often helped with prescription eye drops, removing any foreign objects from the eye, or manually opening tear ducts. If there is extensive blockage of tear ducts or your eyelids are sagging, surgery may be recommended.

Causes of Watery Eyes

• Exposure to substances that cause allergies
• Infections and eye inflammation
• Dry eye syndrome
• Eye injury
• Foreign objects in the eye
• Tear duct blockages
• Sagging eyelids

Watery eyes can be caused by the following:

Dry eye syndrome is one of the most common causes of watery eyes. See your doctor to have the specific cause diagnosed, as this will determine the best treatment.

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How to Prevent Watery Eyes

You can take certain steps to prevent water eyes or reduce their severity.

• Environmental causes: Check on possible causes in your environment, such as cold, dusty, windy conditions or smoky air. If environmental conditions are causing your eyes to water, go inside to protect your eyes.

• Allergies: Evaluate if you are allergic to something, such as grass, tree pollen, dust, or animals. Consider if you have recently changed household products, such as cleaners, detergents, or hair products. Often, making these simple adjustments can provide relief from an allergic reaction and reduce eye-watering.
  
  Treatment for allergic conjunctivitis can include household remedies like cold compresses, artificial tears, and anti-allergy eye drops. Additional helpful measures include avoiding allergens, washing your face after exposure to pollen or dust, showering before bed, and frequently washing your clothes.
  
  Check with a pharmacist for possible home remedies for watery eyes, such as cleaning solutions, eye drops, and over-the-counter allergy medication. 

• Dry eyes: If the source of watering is dry eyes, you may find it helpful to clean your eyelids every day. Use a humidifier to keep the air moist. Take frequent breaks from working on the computer, and set your computer just below eye level.
  
  If you wear contacts, give yourself breaks. Use eyeglasses to rest your eyes to avoid excessive eye dryness.

Treatment Options for Epiphora

Home Remedies

Watery eyes are a common problem and will often improve on their own. Depending on the cause of the watering, home remedies may offer short-term relief.

Follow these tips to reduce watery eyes:

• Stop smoking.
• Avoid drinking excessive amounts of alcohol.
• Take breaks from air-conditioned or heated rooms.
• Avoid overexposure to dusty, dry, or smoky environments.

If you have grit or a foreign object in the eye that is causing your epiphora, follow these steps:

• Avoid rubbing the eye.
• Blink several times so tears can wash out the grit.
• Flush the eye with clean tap water or eyewash.
• Do not put ointment in the eye.
• Seek medical attention if the above steps don’t remove the object.

Medical Treatments

Treatment varies based on the cause of watery eyes. Common reasons may include infection, foreign objects, blocked tear ducts, or sagging eyelids.

• Infection or injury: If watery eyes are caused by infection or eye injury, your doctor may prescribe antibiotics. Depending on the nature of your condition, your doctor may prescribe artificial tears or prescription eye drops.
  
• Foreign object: If there is a foreign object in your eye, your eye doctor will remove it.
  
• Blocked tear ducts: If the tear ducts are blocked, a saline solution may be sufficient to open the clogged duct. In some cases, a thin probe is gently used to manually open the tear duct. For extensive tear duct blockage, surgery may be required.
  
• Sagging eyelids: In this case, the tear ducts may not be in the correct position. The position can vary with the lids sagging toward the inside or outside.
  
  If the eyelid droops toward the outside, it is called ectropion. If it droops towards the inside, it is termed entropion. The recommended treatment for entropion or ectropion sagging is surgery. 

Which Is the Best Treatment?

The best treatment for watery eyes is directly linked to identifying the cause. 

If watery eyes are a result of allergies, you might want to investigate allergy immunotherapy. This treatment offers a way to boost your immune system and gradually expose your body to small amounts of the substances that are causing reactions. 

Traditionally, immunotherapy required frequent visits to your doctor’s office for shots and supervision. Sublingual immunotherapy enables patients to place drops under their tongues. 

This treatment can be done at home, without medical supervision. If allergies are the cause of watery eyes, sublingual immunotherapy may offer relief.

When to See a Doctor for Watery Eyes

While it is natural to have some tear production for lubrication, contact your eye doctor if you notice the following:

• Eye pain
• Swelling in the eye
• A lump in the eye
• Constant watering
• Effects on your vision

Diagnosis of Epiphora

Your doctor will aim to diagnose the cause of your watery eyes.

According to the University of Miami, epiphora is usually classified into two different categories: tears not draining adequately or excess production of tears.

To determine the cause of excess tearing, your doctor will test for a blocked tear duct. This usually includes several steps for precise diagnosis:

• The tear ducts will be flushed with a saline solution.
• A fluorescent dye is delicately inserted into the corner of the eye.
• The dye turns green when mixed with tears.
• Your doctor will check duct drainage after 10 to 15 minutes.

Typically, the tears will wash dye from the eye. However, if dye remains in the eye, it indicates that the tear duct is blocked. 
To determine the extent of the blockage, your doctor may recommend additional tests. These could include a CT scan, or dacryocystography, a specialized type of x-ray.

References

1.  

   Etiology, Diagnosis, Management and Outcomes of Epiphora Referrals to an Oculoplastic Practice. (September 2016). International Journal of Ophthalmology. 

2. Tearing. American Academy of Ophthalmology.

3. Allergic Conjunctivitis. (2017). Community Eye Health Journal.

4. What Is Dry Eye? Symptoms, Causes and Treatment. American Academy of Ophthalmology.

5. Recognizing and Treating Eye Injuries. American Academy of Ophthalmology.

6. Blocked Tear Duct (Nasolacrimal Duct Obstruction). Cleveland Clinic.

7. Watery Eyes. National Health Service.

8. Dry Eyes. National Health Service.

9. Ectropion. National Health Service.

10. Allergies. National Health Service.

11. Allergic Conjunctivitis. John Hopkins.

12. Could Allergy Drops Be the Key to Allergy Relief? John Hopkins.

13. The Tearing Patient: Diagnosis and Management. American Academy of Ophthalmology.

14. Sublingual Immunotherapy: A Comprehensive Review. (May 2006). The Journal of Allergy & Clinical Immunology. 

15. Blocked Tear Duct Diagnosis. American Academy of Ophthalmology. 

16. Epiphora (Excessive Tearing). University of Miami Health System.

17. Secondary Acquired Nasolacrimal Duct Obstruction. EyeWiki, American Academy of Ophthalmology.

18. Etiology, Diagnosis, Management and Outcomes of Epiphora Referrals to an Oculoplastic Practice. (December 2016). International Journal of Ophthalmology.

19. How Important Is the Etiology in the Treatment of Epiphora? (August 2016). Journal of Ophthalmology.