Watery Eyes
Causes and Treatments
Why do I have watery eyes?
Watery eyes, known as epiphora, are a common but uncomfortable problem. The causes can vary: excessive tear production, blockage in the tear drainage system, or even dry eyes. When tears cannot drain properly or are produced in excess, constant tearing occurs. In other cases, a dry cornea can trigger excessive tear production to compensate for the lack of lubrication.
To determine the exact cause, an accurate diagnosis is essential, as treatment varies depending on the underlying problem. Outpatient tests can help identify the origin of the condition, and with a clear diagnosis, a personalised treatment plan can be developed.
Treatments for Watery Eyes
Most cases of watery eyes can be managed with conservative treatments. Improving eye lubrication and cleaning the eyelid margins are often effective measures. However, when the cause is an obstruction in the tear duct system, Dr. van der Veen offers several treatment options, the most common being lacrimal probing for proximal obstructions and dacryocystorhinostomy (DCR), the gold standard procedure, for distal (lacrimal sac and beyond) obstructions. This surgery creates a new connection between the lacrimal sac and the nasal mucosa, resolving blockages in the tear drainage system.
The success rate of DCR surgery is approximately 85–90%. In cases where DCR surgery is not the treatment of choice or when the obstruction is located in a more accessible part of the tear duct, a simple probing with stent placement may be sufficient. In cases where the tear duct openings are very narrow, a procedure can be performed to enlarge them, either surgically or by placing a punctal plug. In rare cases, if the obstruction is irreparable or very close to the tear punctum, Lester-Jones tubes can be implanted to surpass the tear drainage system.
What if I have dry eyes?
In some cases, watery eyes are actually the result of dry eye disease. In these situations, tears evaporate quickly, causing a constant sensation of dryness, itching, or a “gritty” feeling in the eyes. Despite excessive tear production, the tear drainage system cannot handle the overflow properly.
For these patients, artificial tears are prescribed, and many experience sufficient improvement with this treatment alone. In some cases, however, a surgical approach may be necessary to treat dry eyes more definitively.
If you suffer from watery or dry eyes, it is best to consult an oculoplastic surgeon for a thorough evaluation to determine the most appropriate treatment for your specific case.
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