Watery Eye (Watering Eye)
Watery eye (watering eye) due to tear drainage system blockage
Excessive tearing or the bothersome problem of tears overflowing down the cheek is called epiphora (watering eye or watery eye). This can have many different causes. A careful clinical examination by an oculoplastic surgeon is required to determine the underlying cause. The appropriate treatment of a watery eye problem will depend on the underlying cause e.g. if the lower eyelid is sagging away from the eye (ectropion) and causing a watery eye, the treatment will be surgery designed to reposition the eyelid.
Epiphora (watering eye or watery eye) commonly develops from abnormalities in the lacrimal drainage system from scarring due to injury, recurrent infection, the ageing process, or from unknown causes. Surgery is required to improve a watery eye when this is caused by blockages in the tear drainage system. Occasionally a dacryocystogram (a special form of X-ray examination of the tear drainage pathway) or lacrimal scintigraphy (a test utilizing a radiolabelled tracer) is required to assist in the assessment and diagnosis of your condition. (Go to the section on lacrimal surgery for more information).
Watery eye (watering eye) due to overproduction of tears
Paradoxically a dry eye can lead to tearing. Glands in the eyelids (the Meibomian glands) secrete an oily material which lines the tear film covering the cornea, the clear and extremely sensitive window at the front of the eye. The oily secretion slows down the evaporation of the tear film in between blinks. If these glands do not function properly (e.g. in blepharitis), the tear film evaporates quickly leaving the sensitive cornea exposed. This can also affect patients who have an incomplete reflex blink resulting in an “evaporative dry eye syndrome”. The tear glands then produce an excessive volume of tears as a reflex which overwhelms the tear drainage system (as in emotional crying). This often leads to confusion with patients failing to understand why they have been prescribed artificial tears to improve their symptoms!
There are a variety of artificial tear preparations available. Some patients prefer one preparation over another for no scientific reason. It is therefore wise to try different preparations. although the best drop for a patient’s specific problem is usually recommended. If the tears need to be used more frequently than 4 times a day it is better to choose a preparation which is preservative free e.g. Hyabak, Hylotear, Hylo Forte, Theoloz drops, Systane drops preservative free, Viscotears preservative free, Liquifilm tears preservative free, or Celluvisc. Lacrilube ointment or Artelac night time gel instilled at bedtime can also be beneficial.