What Are the Potential Causes of Watery Eyes?
There are many different factors that can contribute to watery eyes. Some of the most common ones include:
- Dry eyes. When the eyes are dry, they can send a signal to the brain to make more tears. This is called “reflexive tearing”. This type of watery eyes generally improves when the dry eyes are properly treated. See AAO EyeWiki's Dry Eyes page for more information.
- Eye infection such as pink eye (conjunctivitis) or corneal ulcers/scratches can cause significant watery eyes. Proper treatment of the infection and/or corneal injury typically leads to resolution of the watery eyes.
- Watery eyes that occur because of allergies can commonly improve with treatment of these allergies.
- Eyelid problem. Watery eyes can develop if the eyelids are not properly positioned to protect the eyes. For example, when the eyelids are too loose, turned inwards, or turned outwards, the eyes can develop significant irritation which leads to watering. In these cases, eyelid surgery can return the eyelids into their proper position, leading to improvement or resolution of the watery eyes.
- Blocked tear duct. The tears drain through small openings on the upper and lower eyelids, then through a passageway into the tear sac, eventually into the nose. This tear duct can develop narrowing or blockage. When this happens, patients may develop watery eyes that tends to be constant, with tears welling up in the eyes and dripping down the face. These patients often feel they need to wipe their eyes many times a day. In these situations, tear duct surgery can recreate an open drainage system as a treatment for the watery eyes.
A narrowing or blockage can develop at various points along the tear duct, and this can occur due to various reasons, including:
- Idiopathic (most patients with block tear ducts do not have any identifiable underlying causes). This tends to be more common in women than men due to women having anatomically narrower tear ducts.
- History of trauma, injury, surgery/procedures involving the tear drainage system or the sinuses/nose
- Eye infections or chemical burn
- Certain chemotherapy agents
- Radioactive iodine treatment
- Inflammation of the sinuses and nasal cavity or mucous membranes
- Lacrimal system tumors
Depending on the location and severity of the tear duct blockage, a variety of treatment options are available. The most common of which are described below:
- Mild narrowing of the tear duct may respond to a procedure where a silicone tube is passed through the tear duct to dilate the lacrimal system. The stent is then removed a few weeks later in clinic.
- More severe blockage of the tear duct may require a surgical procedure called dacryocystorhinostomy (DCR). During this surgery, a new passageway is created to allow tears to drain from the eyes into the nose. This surgery can be performed entirely through the inside of the nose using an endoscopic approach, without any external skin incisions. However, in certain patients with specific conditions and anatomy, an external approach is necessary. This approach would involve a very small incision hidden in a skin crease between the lower eyelid and nose. The incision typically heals very nicely and becomes minimally visible. A silicone stent is also placed after a DCR surgery to help prevent scar formation and keep the new passageway open while it heals. The stent is then removed a few weeks later in clinic.
Tear duct surgery is typically performed under anesthesia with the patient in the operating room.
Recovery depends on the exact type of tear duct surgery performed. This can range from being able to resume normal activities on the same day to needing to avoid strenuous physical activities for 1 week. At your consultation, once Dr. Shannon S. Joseph has evaluated your tear drainage system and determined the most suitable procedure for you, she will go over details regarding your specific procedure and what to expect. Patients typically only have minimal to mild pain after surgery, but postoperative pain medication may be prescribed for the first few days after surgery. Please refer to our additional resources for general pre-operative and post-operative instructions.
Yes. Insurance typically covers tear duct surgery for watery eyes.
Schedule a Consultation
If you are troubled by watery eyes, the first step would be to schedule a consultation during which Dr. Shannon S. Joseph will carefully review your history and perform a comprehensive evaluation of your eyes and lacrimal system. She will perform a lacrimal drainage test to assess for the severity and location of any tear duct blockage you may have. This will allow her to then determine the most suitable treatment option for you, which she will discuss with you in detail and answer all questions you may have. We take care of patients from Troy, Birmingham, Bloomfield Hills, West Bloomfield, Rochester Hills, Rochester, and the rest of Metro Detroit and Southeastern Michigan. Contact us today to schedule a consultation.