Eye Conditions
Watery Eye (Epiphora)
Most of the time, tears are a good sign (even if we’re sad). That’s because tears keep eyes lubricated, free from irritants and infection and, of course, show our emotions. However excessive tearing or a constant watery eye (Epiphora) can be a real nuisance. And in some cases, it is a sign of a more serious problem.
There are many reasons why you may experience epiphora, the medical term for watery eye or the excessive production of tears. The condition can affect newborns right through to the elderly.
Tears are made up of oils, watery liquid, and mucous that are constantly being produced from glands within the eyelids. The tears lubricate and nourish the surface of the eye, then drain away via small openings in the eyelids which connect to the back of the nose (which is why your nose sometimes seems to run when you cry). Epiphora can generally be categorised either due to excessive production of tears or, more commonly, inability of tears to easily drain from the eye surface.
While a blocked tear duct can occur due to the natural aging process it is also a common condition in infants. Before a child reaches 12 months, a small membrane at the end of the nasolacrimal duct (which drains tears) should open. In some infants, this duct does not open and it may be necessary to undergo a small procedure where a probe opens the duct.
In the case of epiphora in adults, treatment can range from introducing a narrow probe into the tear drainage hole of the eyelid (punctum) and injecting salty water, to minor eye lid surgery under local anaesthetic. In cases of more severe blockage in the nasolacrimal duct, a dacryocystorhinostomy operation under general anaesthetic may be necessary.
Action
While it is common to experience watery eyes from time to time due to irritation, dust or fumes, it is persistent watery eyes that should prompt a visit to an eye specialist.
Causes
Epiphora can occur in two ways. Either the tear drainage system is not working properly or the eye produces more tears than necessary. Inflamed eyes, dry eyes, allergies or thyroid eye disease can all contribute to the overproduction of tears.
Treatment
Treatment for epiphora ranges from lubricants and eye drops to relatively straightforward surgical procedures.
FAQ’s
What causes epiphora?
Epiphora is most commonly a result of a tear drainage duct not working properly or the eye producing more tears than necessary. Epiphora can also be a symptom of issues such as conjunctivitis, trauma to the eye, or in some cases, dry eye.
Epiphora can also be due to issues with the nasolacrimal system, responsible for drainage of the tears from the eye surface. Inflamed eyes, dry eyes, allergies and thyroid eye disease can all contribute to the overproduction of tears, and a variety of treatments are available, from lubricants and eye drops to eye surgery in more serious cases.
Why do we produce tears?
Tears are a mixture of water, salt, protein and mucus and are continually produced to keep the eye moist and healthy. Tears originate from small glands within the eyelids. When you blink, the eyelid moves tears across the cornea to the punctum—little openings on the eyelid which drain the tears to the back of the nose. Humans produce tears to keep eyes moist, wash away irritants or debris and help protect the eye from infection.
Is epiphora dangerous?
Watery eye is a common symptom and can be associated with lots of other eye conditions. While epiphora is not serious in most cases, you should speak to your eye specialist if you experience constant watering eyes.
My child has epiphora, what does this mean?
Before a child reaches 12 months, a small membrane at the end of the nasolacrimal duct (which drains tears) should open. In some cases, the membrane does not open and it may be necessary for the child to undergo a small procedure under general anaesthetic where a probe is passed along the passageway open the duct. Epiphora is common among children and occurs in up to 30 per cent of infants.
How is epiphora treated?
The treatment will be very different depending on if the problem is over production of tears or reduced tear drainage. The underlying cause of the over production of tears needs to be identified and treated. For example, if dry eye is the cause, lubricant eye drops and eyelid cleaning techniques may be recommended.
Epiphora caused by reduced tear drainage typically requires a procedure or surgery for treatment. The exact treatment will depend on the location of the blockage. It might involve a narrow probe introduced into the tear drainage hole (punctum) and injection of salty water, or a minor eyelid surgery under local anaesthetic. In more severe cases, there may be a blockage in the nasolacrimal duct and a dacryocystorhinostomy operation under general anaesthetic may be necessary.