Do your eyes constantly water, making it difficult to focus on daily tasks? Excessive tearing, also known as epiphora, can be a bothersome and sometimes serious condition. While occasional tearing is normal and helps lubricate the eyes, persistent watering can indicate underlying issues that require medical attention.

Dr. Saurbhi Khurana, an Experienced Oculoplasty Surgeon, Specialises in Diagnosing and Treating Conditions That Affect the Tear Drainage System.

Understanding the Tear System

Tears are essential for eye health, keeping the surface of the eye moist, washing away debris, and preventing infections. The tear system consists of three main components:

• Tear Production – Tears are produced by the lacrimal glands, meibomian glands, and goblet cells.
• Tear Drainage – Tears flow across the eye and drain through the puncta (tiny openings at the inner corners of the eyelids), passing into the tear sac and then the  nasolacrimal duct, which empties into the nose.
• Tear Balance – A balance between tear production and drainage ensures clear and comfortable vision.

When there is a disruption in this balance, excessive tearing can occur.

Common Causes of Watery Eyes

Several factors can contribute to epiphora (excessive tearing). These can range from minor irritations to structural abnormalities requiring surgical intervention.

• Blocked Tear Ducts: A nasolacrimal duct obstruction prevents tears from draining properly, leading to excessive tearing. This condition is common in infants but can also develop in adults due to aging, infections, or trauma.
• Dry Eye Syndrome: Surprisingly, dry eyes can trigger excessive tearing. When the eyes lack proper lubrication, they overcompensate by producing more tears, causing them to overflow.
• Eyelid Problems: Conditions such as ectropion (outward-turning eyelids) and entropion (inward-turning eyelids) can disrupt normal tear drainage, leading to persistent watering.
• Eye Irritation and Allergies: Environmental factors, allergies, wind, smoke, or exposure to strong perfumes can cause eye irritation, triggering excess tear production.
• Conjunctivitis (Pink Eye): Bacterial, viral, or allergic conjunctivitis leads to red, watery, itchy eyes. It often resolves with appropriate treatment, but persistent symptoms require medical attention.
• Corneal Issues: Corneal abrasions, ulcers, or infections can lead to excess tearing as the eye attempts to heal and protect itself.
• Lacrimal Gland Disorders: Inflammation, tumors, or autoimmune conditions affecting the lacrimal gland can alter tear production and drainage, causing epiphora.
• Neurological Conditions: Certain neurological disorders, like Bell’s palsy, can weaken eyelid function, leading to improper tear drainage.

Symptoms That Require Medical Attention

While mild cases of watery eyes may resolve on their own, persistent or severe symptoms should not be ignored. Seek help if you experience:

• Constant tearing that affects vision or daily activities
• Swelling, redness, or pain around the eyes
• Mucus or pus discharge
• Crusting of the eyelids
• Sensitivity to light
• Recurrent eye infections

Diagnosis: How an Oculoplasty Surgeon Can Help

During your consultation, the following tests may be performed:

• Tear drainage assessment / syringing test – Examining the puncta and nasolacrimal duct for obstructions.
• Dye disappearance test – A special dye is placed in the eyes to observe tear drainage.
• Imaging tests (Dacryocystography or CT scan)
• Slit lamp examination – Detects eye surface abnormalities and infections.

Treatment Options for Watery Eyes

The right treatment depends on the underlying cause of excessive tearing. Here are some possible solutions:

1. Non-Surgical Treatments

• Artificial Tears – Help manage dry eye syndrome and prevent reflex tearing.
• Medications – Anti-inflammatory or antihistamine eye drops for allergies and infections.
• Lid Hygiene – Cleaning the eyelids to manage blepharitis-related tearing.
• Botulinum toxin injection in the lacrimal gland – A non-invasive solution for watering eyes.

2. Surgical Treatments

If non-surgical treatments fail, oculoplastic surgery may be needed. Dr. Saurbhi Khurana offers advanced procedures to restore proper tear drainage and improve eye comfort.

• Punctal Dilation & Probing – Opens up blocked tear drainage passages.
• Dacryocystorhinostomy (DCR) – Creates a new drainage pathway for tears to bypass an obstruction.
• Eyelid Surgery (Ectropion/Entropion Repair) – Corrects eyelid malpositions affecting tear drainage.

3. Tear duct obstruction in babies: lacrimal sac massage if done properly, will open up most congenital tear duct obstructions. If persistent beyond 9 to 10 months of age, a small probing procedure under general anaesthesia can relieve these blocks.

Preventing Watery Eyes

While not all cases of excessive tearing can be prevented, following these simple eye care tips can reduce your risk:

• Protect your eyes from wind, dust, and allergens
• Use lubricating eye drops if you have dry eyes
• Avoid excessive screen time to prevent eye strain
• Practice good eyelid hygiene
• Seek prompt treatment for eye infections or allergies

When to Consult Dr. Saurbhi Khurana

If you experience persistent, unexplained, or bothersome watery eyes, a consultation with an oculoplasty surgeon can provide relief. Dr. Saurbhi Khurana specialises in diagnosing and treating conditions related to the tear drainage system and eyelids.

Book Your Appointment Today

Do not let watery eyes interfere with your daily life. Consult Dr. Saurbhi Khurana for a comprehensive evaluation and personalised treatment plan.

By seeking expert care, you can restore comfort to your eyes and enjoy clear vision without constant tearing.