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Watery eyes

Definition

Watery eyes occur when there is too much tear production or poor drainage of the tear duct.

Alternative Names

Epiphora; Tearing - increased

Common Causes

Tears are necessary for the normal lubrication of the eye and to wash away particles and foreign bodies.

Causes of watery eyes include:

• Allergy to mold, dander, dust
• Blepharitis
• Blockage of the tear duct
• Conjunctivitis
• Environmental irritants (smog or chemicals in the air, wind, strong light, blowing dust)
• Eyelid turning inward or outward
• Foreign bodies and abrasions
• Infection
• Inward-growing eyelashes
• Irritation

Increased tearing sometimes accompanies:

• Eyestrain
• Laughing
• Vomiting
• Yawning

Oddly enough, one of the most common causes of excess tearing is dry eyes. Drying causes the eyes to become uncomfortable, which stimulates the body to produce too many tears. One of the main tests for tearing is to check whether the eyes are too dry.

Home Care

Consider the cause of the tearing. If the eyes feel dry and burn and then begin to tear, consider using artificial tears before tearing occurs. This prevents the reflex tearing.

If the eyes are itchy and uncomfortable, consider allergy as a cause. Over-the-counter antihistamines can be useful. A mucous discharge from the eyes or red eyes may indicate a blocked tear duct or eyelid problem.

Call your health care provider if

Tearing is not an emergency, but it can be very annoying and usually can be treated.

Contact your health care provider if you have:

• Prolonged unexplained tearing
• Red eyes, excess discharge
• Tearing associated with pain in the eye
• Tearing associated with tenderness around the nose or sinuses

What to expect at your health care provider's office

The doctor will take a medical history and examine your eyes.

Medical history questions documenting increased tearing may include:

• Time pattern
  • When did it begin?
  • Is this the first occurrence?
  • Does it occur all the time or off and on?
  • Is there a pattern to the occurrences?
• Quality
  • Is your vision affected?
  • Do you wear or need corrective lenses?
  • Is the increased tearing related to emotional responses?
  • Is the tearing accompanied by pain? Stinging? Itching?
  • Is the fluid clear?
  • Are your eyes red or swollen?
  • Is drainage or crusting present when you wake up?
• Location
  • Does increased tearing affect both eyes?
  • If so, are they affected equally?
• Aggravating factors
  • What seems to cause or increase the tearing?
  • What medications are you taking?
  • Do you have allergies?
  • Are you often exposed to wind, dust, chemicals, sun, or light?
  • Have you had any recent injuries to the eyes?
• Relieving factors
  • What seems to help reduce the tearing?
  • Have you tried eye solutions?
• Other
  • What other symptoms do you have?
  • Is there any loss of vision?
  • Have there been changes in vision?
  • Do you have a headache?
  • Do you have nasal congestion or a runny nose?
  • Do you have joint aches or muscle aches?
  • Has anyone else had similar symptoms recently?

The physical examination may include a detailed eye examination.

Diagnostic tests that may be performed are:

• Culture and sensitivity testing of tear specimen
• Schirmer's test

Intervention:

Once the symptoms are explained, the cause is usually clear. Treatment can include:

• Antibiotics
• Artificial tears
• Surgery
• Topical antihistamines

If you might have a blockage of the tear system, your doctor may use a probe to test the tear drainage system. This is painless. If you have a blockage, you may have surgery to correct the problem. Minor surgery can fix improper eyelid position.

References

Hurwitz JJ. The lacrimal drainage system. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier; 2008:chap 12.