Watery Eyes: Causes, Treatment, Surgery

Watery eyes (medically known as epiphora) are a common condition that can affect daily life and sometimes indicate underlying health issues.

This article provides an expert insight into the causes of watery eyes, the treatment options available, and the effectiveness of surgery.

What causes watery eyes?

Watery eyes occur when there is an imbalance in tear production or drainage, causing excessive tear production or improper tear drainage. Common causes include:

Allergies: Allergens like pollen, dust, or pet dander can irritate the eyes, triggering excessive tear production.
Dry eye syndrome: When the eyes are overly dry, they may compensate for insufficient lubrication with an excess of tears.
Infections: Conditions like conjunctivitis (pink eye) or blepharitis (inflammation of the eyelid margins) leads to watery eyes due to irritation and swelling.

In addition:

Blocked tear ducts: When tear ducts are obstructed, tears accumulate and spill over the eyelids.
Eyelid problems: Structural problems like ectropion (outward-turning eyelids) or entropion (inward-turning eyelids) can disrupt tear drainage, leading to excessive tearing.
Ageing: Tear production and drainage efficiency naturally decline with age, making older adults more prone to watery eyes.

What treatment options are available for watery eyes?

The treatment for watery eyes depends on their underlying cause. Patients can consider the following options:

Over-the-counter solutions: Artificial tears or lubricating eye drops can help balance moisture levels for people with dry eye syndrome.
Medications: Antibiotic or anti-inflammatory eye drops may be prescribed to resolve bacterial infections or soothe irritation. For allergic conjunctivitis, antihistamine eye drops can reduce tearing.
Lifestyle adjustments: Gentle massages near the tear ducts, combined with warm compresses, can assist in clearing blockages, especially in cases of partially obstructed tear ducts.

If structural issues are identified, more advanced treatments might be required. Minor procedures like punctal plugs, which block the tear ducts to conserve tears, can address specific types of dry eye-related watering.

What are the most common surgical procedures for watery eyes?

Surgery is considered when conservative treatments are ineffective or when a structural issue prevents normal tear drainage. The specific procedure depends on the cause of the watery eyes.

A dacryocystorhinostomy is a common surgical procedure that creates a new drainage pathway from the tear sac to the nasal cavity, bypassing the obstructed duct. The procedure can be performed externally, with a small incision on the side of the nose, or endoscopically, with a thin tube inserted through the nasal passages.

In cases of narrow or partially blocked tear ducts, a punctoplasty may be performed. This procedure widens the tear duct openings (puncta) to improve tear drainage. Small silicone stents or tubes may be temporarily placed to keep the ducts open during the healing process.

How successful is surgery for watery eyes?

Surgery for watery eyes is highly effective, with success rates exceeding 90% for procedures like dacryocystorhinostomy. Patients often experience immediate relief from excessive tearing after surgery and recovery times are generally quick, with many resuming normal activities within a week.

Choosing a qualified and experienced oculoplastic surgeon (a specialist trained in managing conditions of the tear ducts, eyelids, and surrounding facial structures) is essential to achieve the best outcomes. Regular follow-up appointments are important to monitor healing and address any complications.