Watery Eyes

What is lacrimation?

Lacrimation is a condition in which tears stream from your eyes even though you are not crying. Excessive lacrimation is also called epiphora.

How does it occur?

The main causes of excessive lacrimation are:

• producing too many tears
• a blockage in the tear-drainage system
• an eyelid that is not in the right position (for example, an eyelid that droops or turns outwards)

Your body produces two types of tears:

• reflex tears (produced when you cry or have something in your eye)
• lubricating tears, which coat the eyes with a tear film at all times.

You may produce too many reflex tears because of:

• eye irritation, which can be caused by:
  • a foreign object in your eye (such as sawdust)
  • something in the air (such as smoke or smog)
  • something you are allergic to (such as pet hair)
  • an infection along the edges of your eyelids
• dry eye syndrome, when you do not produce enough lubricating tears.

You may have a blockage in the tear-drainage system because:

• you were born with it
• you have scarring in the tear-drainage system caused by:
  • injury to your eyes or nose
  • long-term sinus infections
• the tiny openings of the ducts connecting your eyes and nose have become blocked through ageing, injury or infection
• certain drugs cause obstruction (such as those used in chemotherapy)
• a problem with your eyelids prevents your tears from draining normally.

How is the diagnosis made?

Your doctor will ask about your symptoms and examine your eyes, checking for irritation, injury and infection. They will check your eyelids to see whether they are obstructing the tear-drainage system, and may use special drops to reveal any problems on the surface of your eyes. Your ophthalmologist can use a fine probe to open the lacrimal puncta to see whether this solves the problem. Your sinuses may also need to be checked for any obstruction that could be causing the problem, as blocked sinuses can lead to excessive lacrimation.

How is it treated?

Treatment depends on the cause of the lacrimation. Your doctor may recommend one or more of the following:

• If your watering is caused by irritants such as allergens or pollutants in the air, use an air purifier to remove them from the air at work or at home.
• Use warm compresses and topical antibiotics to treat eye infections.
• Take oral antibiotics to treat sinus infections.
• Use artificial tears, as eye drops or ointment, to help relieve dry eye syndrome.
• Have surgery to remove an obstruction in the tear-drainage system. The type of operation depends on the location and extent of the blockage. Some procedures can be performed in the doctor’s office under local anaesthesia. Tubes can be placed in the tear-drainage system, and tiny tubes can be inserted into the lacrimal punctum to keep it open.
• Have surgery to correct the position of eyelids that are blocking the tear-drainage system.

How can I take care of myself?

• Always wear safety glasses or goggles for work or leisure activities in which your eyes could be injured.
• Follow your ophthalmologist’s instructions on using the medicines prescribed for this problem.
• Have a regular eye examination at least every 2 years.
• Wear sunglasses that protect your eyes from ultraviolet (UV) radiation.