Watering eye

Watering eye is a condition where tears are produced without any obvious explanation. The medical name is epiphora.

Watering eye can happen at any age, but it is most common in young babies (0–12 months of age) and people over 60. It can affect one or both eyes.

How tears work

The lacrimal gland constantly produces tears to keep the eyes moist and lubricated. The lacrimal gland is a small gland located above and outside each eye. When you blink, tears are spread over the front of your eyes to keep them moist.

Excess tears usually drain away through tiny channels known as canaliculi, which are found on the inside of the eyes. The tears drain into a tear ‘sac’, then flow down a tube (tear duct) and into the nose.

If your tear ducts become blocked or narrowed, or if you have an eye infection, excess tears can build up and cause the tear ducts to overflow.

Outlook

Watering eye can be treated.  Treatment depends on how severe the problem is and what is causing it. Mild cases of watering eye may not need treatment at all.

Eye conditions such as watering eye may have implications for driving.

Blocked tear ducts

Babies are sometimes born with tear ducts that have not fully developed. This can cause their eyes to water. As their tear ducts finish developing (usually within a few weeks of birth), the problem disappears.

In adults, a blocked or narrowed tear duct is the most common cause of a watering eye. Over time, the tear ducts can become narrowed, often because of inflammation (swelling).

If your tear ducts are blocked or narrowed, your tears will be unable to drain away and will remain in the tear sac. The tear sac may become infected and your eye will produce a sticky liquid. You may also have a swelling on the side of your nose, next to your eye.

Occasionally, the canaliculi (narrow drainage channels on the inside of your eyes) may become blocked. This can be due to inflammation or scarring.

Excess tears

If your eyes become irritated, they will automatically produce extra tears to wash away the irritant. Irritants that can cause extra tears to be produced include:

• chemical irritants, such as onions or fumes,
• an eye infection, such as infective conjunctivitis,
• inflammation caused by an allergy, as in allergic conjunctivitis,
• an eye injury, such as a scratch or a piece of grit that becomes lodged in the eye, or
• an inward-growing eyelash (entropion).

A watering eye can also be caused when the lower eyelid turns outwards away from the eye. This is known as ectropion. If this happens, your tears may not drain away properly.

Treatment for watering eye depends on how severe the problem is and what is causing it. Treatment may not be necessary in mild cases.

Treating irritation

If infective conjunctivitis is causing watering eye, the ophthalmologist may advise you to wait for a week or so to see if the condition resolves itself before prescribing a course of antibiotics.

If allergic conjunctivitis is causing watering eye, antihistamines may be prescribed to help reduce the inflammation (swelling).

If the cause is an inward-growing eyelash (entropion) or a foreign object (such as a piece of grit) in your eye, the eyelash or object can be removed.

If your lower eyelid turns outwards (ectropion), a minor operation under general anaesthetic may be recommended. The most common procedure involves tightening the tendon that holds the outer eyelid in place to give it extra support.

Treating blockages

Blocked tear ducts can be treated with surgery.

Dacryocystorhinostomy (DCR) is a common surgical procedure used to treat blocked tear ducts. It involves creating a new channel from the tear sac to the inside of your nose. This allows tears to bypass the blocked part of your tear duct.

If your canaliculi (the drainage channels on the inside of your eye) are narrowed but not completely blocked, it may be possible to use a probe to widen them. If the canaliculi are completely blocked by tears, an operation to drain them may be required.

Treating watering eye in babies

In babies, watering eye often resolves itself within a few weeks without treatment. If a sticky liquid forms around your baby’s eyes, remove it using a piece of cotton wool that has been soaked in sterile water (water that has been boiled and then cooled).

Massaging the tear ducts may help dislodge tears that have collected in the upper part of your baby’s tear duct, as well as encouraging the tear duct to develop. This can be done by applying light pressure with your finger and thumb to the outside of your baby’s nose.

You do not need a referral to see a Moorfields Private consultant. If you know which consultant you would like to see, please contact their private secretary to make an appointment or receive further information, or email us at enquiries@moorfields-private.co.uk