Epiphora (Watery Eyes): Symptoms, Causes, Treatment

What are the symptoms of epiphora?

Epiphora, also known as watery eyes, is a condition characterized by an overflow of tears onto the face, often due to an excessive production of tears or inadequate drainage. Symptoms of epiphora can include:

1. Excessive tearing: Frequent or constant tearing, which can result in watery eyes.
2. Wetness around the eyes: The skin around the eyes may be constantly damp or wet.
3. Blurred vision: Tears can temporarily blur vision, especially if they accumulate on the surface of the eye.
4. Mucus discharge: In some cases, there may be a thick or sticky discharge from the eyes.
5. Irritation: The skin around the eyes may become irritated or red due to constant moisture.
6. Crusting: In some cases, dried tears or discharge may crust around the eyes, especially upon waking.

It’s important to consult with a healthcare professional if you experience persistent or bothersome symptoms of epiphora, as they can help determine the underlying cause and recommend appropriate treatment.

What are the causes of epiphora?

Epiphora, or excessive tearing, can be caused by a variety of factors that affect the production, drainage, or distribution of tears. Some common causes include:

1. Blocked tear ducts: Narrow or blocked tear ducts can prevent tears from draining properly, leading to excessive tearing. This blockage can be caused by infection, inflammation, or a congenital issue.
2. Dry eye: Paradoxically, dry eyes can stimulate the production of more tears as a reflex response, leading to watery eyes.
3. Eye irritation: Foreign bodies, allergies, or environmental irritants can cause the eyes to produce more tears as a protective mechanism.
4. Eyelid problems: Conditions like ectropion (outward turning of the eyelid) or entropion (inward turning of the eyelid) can disrupt the normal distribution of tears over the eye’s surface, leading to excessive tearing.
5. Conjunctivitis: Also known as pink eye, this condition can cause inflammation of the conjunctiva, leading to excessive tearing.
6. Allergies: Allergic reactions can cause the eyes to become watery as part of the body’s response to the allergen.
7. Infections: Eye infections, such as those caused by bacteria or viruses, can lead to increased tear production and watering eyes.
8. Eyelash problems: Ingrown eyelashes or eyelashes that grow abnormally can irritate the eye and cause excessive tearing.
9. Certain medications: Some medications, such as certain eye drops or drugs used in chemotherapy, can cause watery eyes as a side effect.
10. Other eye conditions: Conditions like blepharitis (inflammation of the eyelids), corneal ulcers, or uveitis can lead to excessive tearing as a symptom.

Determining the underlying cause of epiphora is important for appropriate management. A healthcare professional, such as an ophthalmologist or optometrist, can help diagnose the cause and recommend treatment options.

How is epiphora diagnosed?

Diagnosing epiphora, or excessive tearing, typically involves a thorough eye examination and sometimes additional tests to determine the underlying cause. Here’s what a diagnosis might involve:

1. Medical history: Your healthcare provider will ask about your symptoms, when they started, and if you have any other relevant medical conditions or eye problems.
2. Physical examination: A physical examination of your eyes and eyelids will be conducted to look for any abnormalities or signs of infection.
3. Tear drainage evaluation: Your healthcare provider may perform tests to evaluate the drainage of tears from your eyes. This can include using special eye drops to see how quickly tears drain from your eyes, or placing a dye in your eyes to see if tears are draining properly.
4. Schirmer test: This test involves placing a small strip of paper inside the lower eyelid to measure tear production. It can help determine if your tear production is normal, low (indicating dry eyes), or high (indicating reflex tearing).
5. Fluorescein dye disappearance test: A special dye is placed in your eyes, and then the healthcare provider observes how quickly the dye disappears. This can help determine if tears are draining properly.
6. Imaging tests: In some cases, imaging tests such as a CT scan or MRI may be recommended to evaluate the tear drainage system and surrounding structures.
7. Allergy testing: If allergies are suspected, your healthcare provider may recommend allergy testing to identify the specific allergens that may be triggering your symptoms.

Based on the findings of these tests, your healthcare provider can determine the underlying cause of your epiphora and recommend appropriate treatment.

What is the treatment for epiphora?

The treatment for epiphora, or excessive tearing, depends on the underlying cause. Here are some common treatment approaches:

1. Tear duct massage: For infants with blocked tear ducts, gentle massage of the tear duct area can help open the duct and improve tear drainage.
2. Warm compresses: Applying warm compresses to the eyes can help open blocked tear ducts and improve tear drainage.
3. Medicated eye drops: Eye drops may be prescribed to treat underlying conditions such as dry eyes or eye infections.
4. Antibiotics: If the excessive tearing is due to an eye infection, antibiotics may be prescribed.
5. Surgery: In cases where there is a blockage in the tear duct that does not improve with other treatments, surgery may be recommended to open or repair the tear duct.
6. Punctal plugs: These are small devices inserted into the tear ducts to block drainage temporarily. They can help conserve tears and reduce symptoms of dry eyes.
7. Treatment of underlying conditions: If epiphora is caused by an underlying condition such as allergies or eyelid problems, treating the underlying condition can help reduce tearing.
8. Lifestyle changes: Avoiding environmental irritants, using humidifiers, and practicing good eye hygiene can help manage symptoms of epiphora.

It’s important to consult with an eye care professional to determine the underlying cause of epiphora and to receive appropriate treatment.