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WATERY EYES: Also known as Epiphora

Watery Eyes is another one of those common symptoms that […]

By Published On: 19 February 20123.4 min read

Watery Eyes is another one of those common symptoms that annoys patients and practitioners.  Like dry eyes it is often ignored even though most watery eye causes have a solution if analysed and treated properly.

So why are you crying when you’re not sad? The easy answer is that you have epiphora – watery eyes. The more challenging part is figuring out what causes those watery eyes!

Basically, there are two main causes of epiphora – either from a blocked tear duct, or an overproduction of tears due to irritants. Once the main cause is identified, a sub-cause has to be identified, such as canaliculitis, ectropion, conjunctivitis (allergic, bacterial, or viral), dacryocystitis, or even ingrown eyelashes, and other causes.

  • Canaliculitis: Tears drain from the puncta (at the inner corner of your eye) into the canaliculus. If the canaliculus becomes inflamed or blocked, the tears will “back up” into the eye, and spill over.  The picture below shows a blocked infected canaliculus. This needs treatment with antibiotics.
  • Dacryocystitis: Congenital dacryocystitis is a rare but serious condition in newborns and must be treated promptly. Dacryocystitis in adults is when the tear sac itself is inflamed, which blocks the ducts and prevents tear (lacrimal) drainage. This can cause overflow of tears ans watery eyes.
  • Conjunctivitis: Allergies, bacteria, and viruses are all causes of conjunctivitis – the lining of the eyelids becomes irritated and swells – this membrane is called the conjunctiva, hence the name conjunctivitis. Watery eyes are commonly seen with this condition.
  • Ingrown eyelashes: Known as trichiasis (trick-eye-ah-sis) among medical professionals, this is exactly like it sounds – the eyelash grows inward towards the the eye, and can cause infections and scarring if you do not treat it promptly.
  • Ectropion: This condition should be treated right away to prevent infections and scarring to the eye. Ectropion is the name of the condition where the eyelid, typically the lower eyelid, folds inward towards the eye. It is not only the cause of watery eyes, it is also quite uncomfortable. Treatment is a simple surgery, and the outlook for patients with ectropion is good, especially if it is treated prior to corneal damage.
  • Entropion is the opposite of ectropion, where the bottom lid droops down and away from the eye.  This in turn takes the puncta (drain of the eye) away from the tears of the eye, which then cannot drain away.  They overflow and watery eyes or epiphora is the consequence.  Surgery by an oculoplastic surgeon is the way to fix this problem.
  • Foreign objects or eye injury: Dirt, sand, grit, pebbles, pollen, dander, and dust can get into the eye, making the tears produce in an attempt to wash out the foreign object. If the eye is injured, you will also produce tears to try to keep the eye safe.
  • Dry Eyes can be a cause of watery eyes!  This sounds ridiculous but can happen when the eyes get excessively dry.  Irritation finally sets in, which them stimulates the tear gland to over produce tears.  the problem with these tears that are produced in reflex to a dry eye is that they are usually quite salty.  Patients with this condition typically complain of their eyes burning and stinging.
  • Other causes: Other causes of watery eyes can include simple allergies, sleep deprivation, eyestrain, and emotional stress.

You can see that the causes of watery eyes are quite diverse, and many causes require immediate treatment to avoid damage to the eye. While the above list is not an exhaustive one, it is a list of the most common causes. Many of these causes can be treated with good results, particularly if they are treated early, before the condition has a chance to do any damage to the eye (which could result in permanent vision loss).

Tears are a necessary part of protecting the eye, but a constant overproduction can be not only annoying, but dangerous (especially if you’re trying to drive) in some cases. If you’re having trouble with watery eyes, consult us at The Eye Practice for a proper diagnosis and then a treatment plan.


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