Lacrimation (Watery Eyes)
What is watery eyes?
The main function of tears is to moisturize and cleanse the surface of the eye. Watery eyes is the overflow of tears from the surface of the eye as a result of increased tear production (lacrimation) or decreased absorption (epiphora) for various reasons.
Our tears are mainly produced by the lacrimal gland located in the upper outer part of the eye, from where they travel to the inner part of the eye. By the help of the negative pressure created during each opening and closing of the eye, it passes through the punctum and canaliculi, one each on the upper and lower eyelids, to the lacrimal sac. From there, the lacrimal pump function allows the tears to flow into the nose and the tears that pass into the nose are absorbed by the nasal mucosa.
Excessive secretion of tears reflexively from the lacrimal gland (lacrimation) caused by some eye diseases, or narrowing and blockages in the tear duct starting from the punctum to the nose, cause tears to pool in our eyes and even overflow from the lids and flow down our cheeks.
What are the symptoms of watery eyes?
The only symptom of a watery eye can be tears pooling in between eyelids and overflow from eyelids down to our cheeks as well as symptoms related to underlying diseases can be seen either. There may be a persistent wet appearance in the eyes as if patient has been crying, sticking of the eyelashes, frequent flow of tears to the cheeks and accumulation of tears around the eyes, or irritation around the eyes caused by constant wiping of the tears flowing to the cheek with a napkin.
Symptoms related to the underlying cause (itching, redness, burring, etc.) may also accompany these symptoms. Especially in patients with dry eye disease, reflex lacrimation in addition to symptoms of burning, stinging and dryness may paradoxically cause tears to flow out.
In some patients, as a result of tear duct obstruction, the fluid accumulated in the tear sac becomes infected and an infection called dacryocystitis may be observed. In the presence of this infection, swelling, redness and severe pain around the eye occur. Acute dacryocystitis is a disease that generally requires emergency medication or even emergency surgery. However, in patients with long-term obstruction, only occasional swelling and continious discharge and watering of the eyes may be observed. The treatment of patients with this type of chronic dacryocystitis is only surgical.
How is watery eyes diagnosed?
Watery eyes are diagnosed by an ophthalmologist after a detailed examination. First of all, it is necessary to clearly understand whether the watering is due to excessive production (lacrimation) or decreased drainage (epiphora).
Following the physical examination, tests for the underlying cause can be planned. Irrigation of the tear drainage system with sterile saline solution (lavage), dacryocystography and dacryoscintigraphy, computed tomography (CT), magnetic resonance imaging (MRI), dry eye tests and tests for eyelid functions can be performed.
Treatment plans are made based on the diagnosis to be made as a result of all these examinations and tests. While the treatment of excessive watering can usually be done with medications, the treatment of canal stenosis or obstruction can generally be done with surgery.
What are the causes of watery eyes?
The causes of watery eyes are very diverse. As mentioned earlier, we should first consider the causes under two main headings: excessive tearing and decreased drainage. Emotional stress, crying, laughing or yawning can cause excessive tearing. However, this condition is short-term and temporary. If watery eyes develop continuously or intermittently without such a condition, the underlying cause should be investigated.
The main cause of watery eyes in infancy is congenital blockage of the tear duct. When we are born, our tear ducts are blocked and they normally open within days. However, this opening may be delayed in some babies.
In more than 90% of babies with blocked tear ducts, the duct opens spontaneously within the first year of life. During this period, it is recommended to massage over the lacrimal sac so that the canal opens faster. However, in very few cases, the ducts cannot be opened spontaneously and babies are given a procedure called probing to open their own ducts with a wire.
In adulthood, the most common cause of watery eyes is excessive tearing as a result of irritation due to allergies or dry eye disease. However, canal obstruction is another common cause of watery eyes in older women.
Watering caused by excessive lacrimation due to irritation is generally treated with drops and ointments. However, in patients with tear duct obstruction, the treatment is mainly surgical.
İnfection / Blockage of the tear duct
Dry eye disease
Foreign body in the eye
Various diseases related to the transparent layer of the eye (cornea)
Eyelid turning outward (ectropion)
Eyelid turning inward (entropion)
Inflammation of the base of the eyelash (blepharitis)
Use of screens such as computers, phones, tablets
Environmental causes such as wind, sun, bright light
Cold, flu or allergic rhinitis
What causes tear duct obstruction?
Tear duct obstruction can be congenital or acquired. Congenital tear duct obstruction may occur because the ducts do not develop in the womb or the membranes covering the duct opening do not open completely.
In adulthood, obstructions can be observed at different levels (upper and lower punctum, upper and lower canaliculi, common canaliculi at the entrance of the sac, tear sac and duct). In older women, obstruction may develop idiopathically following hormonal changes or may be caused by infection or systemic – rheumatic diseases.
How is tear duct obstruction treated in infants and children?
Tear duct obstruction is managed with non-invasive treatments in the first 12 months of life. First of all, it is recommended to massage over the lacrimal sac and use topical antibiotic drops if yellowish discharge develops. In this age group, tear duct obstruction opens spontaneously in 90% of cases without the need for surgical intervention.
Interventional treatments should be planned in the presence of acute lacrimal sac infection, orbital infection or in children whose tear duct obstruction does not resolve spontaneously within the first year of age.
First of all, probing is performed under general anesthesia. Performing the probing procedure before the age of 2 increases the success rate. In cases where this treatment fails, advanced treatment methods (such as silicone intubation, external or endoscopic dacryocystorhinostomy) can be used.
Why is tearing seen in dry eye disease?
Any condition that causes discomfort on the eye surface, damage to the cornea and consequent irritation can increase tear production (excessive lacrimation). In dry eye disease, the corneal surface is not adequately protected due to a deterioration in tear quality. Therefore, the lacrimal gland reflexively produces more tears.
Especially in evaporative type and hybrid type dry eye disease, the tears produced do not contain sufficient quantity and quality of oil layer and evaporate rapidly from the eye surface. As a result, the corneal layer remains exposed, causing complaints such as dryness, stinging and burning, and then reflex watering.
What helps with watery eyes and how does it disappear?
Treatment of watery eyes is based on correcting the underlying cause. Reducing wind, bright light, air-conditioned environments, use of virtual screens and allergens can reduce watery eyes to some extent. Some simple measures such as wearing sunglasses in sunny weather, not watching television or looking at the screen in very dark environments can reduce complaints.
However, these measures are insufficient in conjunctivitis, corneal and lid diseases. The treatment of tear duct obstruction or eyelid disorders is often surgical correction. It would be best to be examined by an experienced oculoplastic surgeon to determine the underlying cause and the treatment to be performed and to learn the treatment options from your doctor.
Watery Eye Treatment Prices 2023
The causes of watery eyes vary. In order to fully understand the cause of your watery eyes and to evaluate how to treat this cause, you need to have a detailed examination. We are waiting for you in our clinic so that treatment options can be planned. You can contact us to get information about Eye Watering Treatment Prices 2023.