The human tear is made in a gland under the skin of the eyelid that flows over the surface of the eyeball and drains into the naso-lacrimal ducts into the nose. Necessary for normal lubrication of the eye and to wash away foreign substances and allergens, normal tear production is rarely something one thinks much about. But when natural function goes awry, it can cause something called epiphora, or more simply put, excessive tearing.
Epiphora occurs when your body makes more tears than it can remove by way of drainage or evaporation. Although temporary excessive watering can occur as a result of emotions, allergies, or the elements, other issues can cause a more longstanding and concerning issue. In adults, this can be commonly caused by diseases, disorders, or aging. In children, epiphora is most often caused by a blocked or incompletely opened tear duct.
Causes of Epiphora
Epiphora can be caused by many passing and chronic conditions. If the condition persists, an ophthalmologist can best identify the cause of epiphora and decide the best route of treatment.
Epiphora can be attributed to any of the following causes:
- Ingrown eye lashes
- Dry eye
- Foreign substances
- Blepharitis or eyelid laxity
- Naso-lacrimal duct blockages
- The common cold, hay fever, or eye/tear duct infections
- Pink eye
- A blow to the face
- Allergies or chronic sinusitis
- Congenital or early-onset glaucoma infants
- Granulamatosis, rheumatoid arthritis, or sarcoidosis
- Radiation therapy
- Seventh nerve palsy or Sjögren’s syndrome
- Eye or nose surgery
- Thyroid disorders
- Tear drainage tumors
- Antihistamines, beta blockers, diuretics, pain relievers, or sleeping pills
- Blockage of the tear duct
Often epiphora resolves and intervention is not necessary. Although not usually cause for emergency, this issue should be addressed if it becomes more than a transient discomfort. If prolonged and unexplained tearing or excess discharge, redness, and pain occur, it’s important to locate the cause of the discomfort and assess proper treatment by a professional.
Artificial tears can help manage watery eyes due to irritation, dry eye, or foreign objects, and antihistamines can help solve this issue if watery eyes are the symptom of allergies. If symptoms persist, visiting an ophthalmologist can help you determine the underlying cause of your symptoms. Ophthalmologists can perform tests to determine whether your issue is due to problems with your naso-lacrimal ducts or improper eyelid or eye lash positioning, and whether your issue can be solved permanently through a surgical procedure. Many causes of chronic epiphora can be quickly remedied through a minor surgical procedure with little or no necessary recovery time.
Children and infants often experience epiphora due to a poorly developed or narrow tear duct. This condition, called dacryostenosis, can be resolved by a painless procedure in which these ducts are probed to help open up the tear drainage system. If a simple probing procedure does not completely resolve the issue, stents and tubes can be placed to help open up this drainage system.
Improper Eyelid or Eyelash Positioning
Watery eyes can also be due to improper eyelid or eyelash positioning. Minor surgery can fix improper eyelid positioning. Often times this improper positioning can cause dry eye, and this condition results in the body reacting by overproducing tears. In-growing eyelashes, called trichiasis, can also irritate the eye and cause watering. This may be remedied by removing the lashes, although the issue may reoccur.
Poor Eyelid Function
Another cause of watery eyes can be poor eyelid function. The eye must close correctly in order to properly spread the tear film over the eye, and poor eyelid function may prevent proper closing of the eyelids. A condition called ectropion can cause a drooping and pulling away of the lower eyelid, which is often seen in older individuals. This issue can be easily remedied with a minor eyelid surgery to tighten the drooping eyelid.
Persistent eye watering should be examined by an ophthalmologist and a proper treatment plan executed in order to aid in better vision and a healthier eye. Epiphora can be caused by a multitude of issues, many of which are transient or easily resolved by a simple surgical procedure. Ectropion, trichiasis, and dacryostenosis can all be resolved with simple procedures that involve painless probing, eyelash removal, or eyelid tightening.
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