Watery eyes (epiphora): Causes, treatments, and remedies (original) (raw)

Watering eyes can occur because the body is producing more tears than usual, or because the tears are not draining away. Allergies, blocked tear ducts, dry eye, and other conditions could cause this.

The medical term for watery eyes is epiphora. When there is too much fluid, or tears are unable to drain properly through the nasolacrimal system, tears can overflow onto the face.

Epiphora can develop at any age, but it is more common in newborns and older adults. It may affect one or both eyes. However, it is possible to treat.

Read on to learn the causes and treatments for watering eyes, as well as home remedies and when to contact a doctor.

• blocked tear ducts, which prevents tears from draining
• reflex tearing, which is when the body produces tears in response to something else, such as an irritant
• excessive production of tears, which is rare

Blocked tear ducts

Tear ducts are responsible for draining eye fluid. If they are too narrow, underdeveloped, or blocked, they may not work as they should.

Some people have underdeveloped tear ducts at birth. This is known as congenital nasolacrimal duct obstruction (NLDO) and it is common. It usually resolves on its own within a few months.

In adults and older children, the tear ducts may be blocked or too narrow. Narrowed tear ducts can develop as a result of inflammation or scarring.

If the cause is inflammation, the symptoms may include watering in one or both eyes, as well as:

• blurred vision
• swelling
• crusting of the eyelids
• eye redness

The symptoms may worsen after exposure to wind or cold temperatures.

If the tear ducts are narrowed or blocked, tears will not drain away and will build up in the tear sac. Stagnant tears in the tear sac increase the risk of infection. If this occurs, the eye will produce a sticky liquid. Infection can also lead to inflammation on the side of the nose, next to the eye.

Reflex tearing

Reflex tearing is when the eyes temporarily overproduce tears in response to something else. For example, when a person yawns, laughs, or vomits, they may have watery eyes.

This is typical and not cause for concern, but if the watering is continuous, there may be another problem. This could include:

• Irritants: Irritation from exposure to smoke, cold winds, chemical fumes, or even onions may lead to eye watering. This can help to wash the irritant away.
• Foreign object or injury: Dirt, grit, or eyelashes can all get into the eye and potentially induce watering. Sometimes, the watering helps to dislodge the object, but if the object scratches the eye, it may continue a while longer. If the cause is an ingrowing eyelash, or trichiasis, the watering may persist until the eyelash is gone.
• Infection: There are many types of eye infection that could cause watering, including infective conjunctivitis, or pink eye, as well as keratitis.
• Chalazion or stye: These lumps on the eyelid occur due to blockages of the hair follicles or oil glands around the eye, and may also result in eye watering.
• Allergies: Allergic conjunctivitis occurs when an allergen makes contact with the eye, leading to inflammation and tearing.
• Dry eye: Some people have an imbalance of the components in tears: water, oil, and mucus. This may interfere with the even spread of liquid across the eye, leaving dry patches that become sore and irritated.
• Ectropion: This condition involves the lower eyelid turning outward. This also leaves part of the eye exposed to the air, resulting in dryness and tear production.
• Other conditions: Some autoimmune conditions and skin conditions can also affect the eyes, leading to inflammation and tearing.

Depending on the cause, overproduction of tears due to irritation may occur alongside symptoms such as redness, swelling, itching, blurred vision, pain, and increased sensitivity to light.

Tear overproduction

Rarely, watering eyes occurs due to excessive tear production. This can happen if the nerves involved in controlling tear production are not functioning as they should.

For example, if a person has a type of facial paralysis, such as such as Bell’s palsy, the nerves may regenerate afterwards in a way that promotes excessive tearing.

Treatment for watery eyes depends on the cause, how severe the symptoms are, and whether other symptoms are present.

In mild cases, doctors may recommend monitoring the patient’s progress without taking further action. If the symptoms do not clear up on their own or they worsen, treatment may be necessary.

The different treatment options for each cause of watery eyes include:

• Irritants: Treating eye irritation may involve avoiding the irritant, rinsing the eyes with clean water, or wearing protective equipment when dealing with chemicals and smoke.
• Infections: Watering due to viral conjunctivitis typically improves on its own, whereas doctors treat bacterial conjunctivitis with antibiotics.
• Foreign objects: For an inward-growing eyelash or other foreign object lodged in the eye, the doctor will remove it.
• Blocked tear ducts: If the drainage channels on the inside of one or both eyes are narrow but not entirely blocked, the doctor may use a probe to make them wider. If they are completely blocked, surgery can create a new channel from the tear sac to the inside of the nose. This allows the tears to bypass the blocked part of the tear duct. This surgical procedure is known as a dacryocystorhinostomy.
• Ectropion: If the eyelid turns outwards, the patient may need to undergo surgery in which a doctor tightens the tendon that holds the eyelid in place. This condition can affect one or both eyelids.

Treatment for eye watering in babies

In newborns, watery eyes due to NLDO usually resolves on its own. In 70% of infants, the symptoms resolve by the time they are 3 months old, and 90% before they reach their first birthday.

To relieve symptoms, caregivers can gently massage the tear ducts 2–3 times per day. To do this, apply light pressure with the finger and thumb to the outside of the nose. This may help tears drain.

Sometimes, a sticky liquid may form around the baby’s eye or eyes. A caregiver can use a piece of cotton wool soaked in sterile water to clean this away. If an infection occurs, a doctor may give topical antibiotics.

Home remedies can treat some cases of watering eyes without a person having to see a doctor, but whether they work depends on the root cause.

It may help to:

• take regular breaks from reading, watching TV, or using the computer
• lubricate the eyes with eye drops
• hold a warm, damp cloth over the affected eye and massage the eyelid to release any blockages
• using an eye wipe to remove any dirt and debris from the eyes and eyelids
• use over-the-counter medication to relieve allergy symptoms

If the following symptoms occur, a person should contact a doctor:

• vision changes
• pain or swelling around the eyes
• a feeling that something is in the eye
• persistent redness in the eye
• tearing and pain that a person feels first thing in the morning, which can suggest a recurrent corneal erosion, or the outer layer of the cornea wearing away
• burning and discomfort when blinking in the morning, which may be related to the eyes being too dry

Epiphora is fairly easy to diagnose with a physical examination. A person may need to see an optometrist or ophthalmologist for this, as they will have the right equipment to assess the eye.

The doctor may look for signs of infection, injury, lesions, or other visible causes that could explain the symptoms. If there are no apparent causes, they may ask questions about when the symptoms began, how severe they are, or what makes them better or worse.

If blocked tear ducts are a possibility, the doctor may use anesthetic to examine them. They may also insert liquid into a tear duct to check whether it then comes out of the patient’s nose. If the person feels the fluid in their nose, their tear system is not blocked. If it is blocked, the liquid will move back toward the eye.

Eyes can water for many reasons. They may water excessively if the eyes are producing more tears than usual, or if the channels that drain tears away become blocked or narrowed. In newborn babies, this is fairly common, as the tear ducts are still developing.

Sometimes, watering eyes do not require any treatment, or a person can manage them with home remedies, such as avoiding irritants and keeping the eyes moist. But if the watering comes with swelling, pain, discharge or crusting, vision changes, or other symptoms, a person should speak with a doctor.