What's Behind Watery Eyes?

When you produce too many tears, or when normal tear drainage is blocked, your eyes may get a little watery. The influx of tears can spill onto your eyelids and cheeks, as though you are crying. Is there anything you can do about it? Yes, depending on the cause.

Tears are essential for nourishment and lubrication of the human eye. Every time you blink, you're washing your eyes with tears produced by the lacrimal glands in your upper eyelids. These glands will produce extra tears in response to irritation and inflammation. Tears normally drain out of the eye and into the nose through ducts located in the corners of your eyes.

But people with watery eyes are usually experiencing an overproduction of tears, which are made up of water, oil, and mucous. These excess tears can be caused by:

• Dry-eye syndrome. It may not make sense, but dry-eye syndrome often leads to watery eyes. When eyes dry out, they become irritated and uncomfortable. That prompts the lacrimal glands to produce so many tears that they overwhelm the eye's natural drainage system. Tear production tends to lessen with age, so dry eyes are more common in older adults. Some medical conditions and medications can also lead to dryness, as can a dry and windy environment. But the most common cause of dry eye syndrome is a chronic condition called keratoconjunctivitis sicca (KCS). People with this condition make tears, but the tears do not contain enough water. In addition to excessive tearing, symptoms of dry eye syndrome may include blurred vision, itchy eyes, or burning eyes. One remedy for milder cases of dry eye is using over-the-counter artificial tears. Other treatments include prescription drugs.
• Allergies. Substances that cause an allergic reaction are called allergens. Reaction to allergens can cause your eyes to become red and irritated, prompting tear production, itching, and burning. The most common outdoor causes of allergic eye symptoms are grass, tree, and weed pollens. The most common indoor causes are pet dander, dust mites, and molds. Other causes of itchy, watery eyes that are not true allergens include exhaust fumes, aerosol sprays, perfumes, and cigarette smoke.
• Infections. Part of your body's response to an eye infection can be to produce excess tears. This is an effort to keep the eye lubricated and wash away germs and discharge. Conjunctivitis (infection of the thin, clear membrane covering most of the eye) and blepharitis (infection of the eyelid margins) are two infectious diseases known to cause watery eyes. "Pink eye" is a common term for conjunctivitis. Causes include bacteria, fungi, and, most commonly, viruses. Wearing contact lenses may increase the risk of conjunctivitis. Conjunctivitis can occur in one or both eyes. Symptoms may include eye pain, blurred vision, redness, gritty feeling in the eyes, discharge, and crusts that form at night, along with increased tearing.
• Irritants. Your eyes produce excess tears in response to other types of irritation, such as dry air, bright light, wind, smoke, dust, an eyelash, or exposure to chemicals. Eyestrain also can cause watery eyes.

Watery eyes may also be due to a blockage of the ducts that normally drain away tears, although this is less common. This blockage is called lacrimal stenosis. The overflow of tears it causes is called epiphora. Infections can spread into the lacrimal duct from the inside of the nose and cause scarring. Trauma and surgery of the nose are other causes of lacrimal duct blockage.

Another watery eye type is related to poor eyelid function. In order for tears to spread evenly over the eyes and be pushed to the corners of the eye for proper drainage, the eyelids need to close correctly. One of the most common causes of this type of watery eye problem is called ectropion. This condition is a drooping and pulling away of the lower eyelid. It is usually seen in older people who gradually develop a weakness of the lower lid. Ectropion may cause the eyes to be dry, sore, red, and burning. It may also increase the risk of eye infection.

Most often, watery eyes are a symptom rather than a cause of eye distress. Sure, they can be an annoyance, but unless they are accompanied by eye pain or redness, excess tears are usually not a serious problem.

How Watery Eyes Are Diagnosed and Treated

You may be able to figure out the cause of your watery eyes on your own:

• If your eyes feel dry, raw, and uncomfortable just before they begin to water, you are probably experiencing dry eye syndrome.
• If your eyes are itchy and swollen, allergies are the likely culprit.

In these cases, over-the-counter remedies are available:

• Prescription and over-the-counter drops for dry-eye syndrome. If dry eyes are causing excess tearing, you can head off that response by using artificial tears to keep your eyes moist. Artificial tears can also help wash away any irritants like dust that may be causing your eyes to water. Using artificial tears without preservatives — in individual disposable applicators — is best.
• Prescription and over-the-counter medicated eye drops help treat allergies that are causing watery eyes by interrupting the body's immune response.

Some steps you can take to prevent dry, itchy, eye irritation include remembering to blink regularly when using your computer and taking occasional breaks to rest your eyes and prevent eye strain. Increase the humidity in your home or work environment if your eyes are dry and irritated. Wear sunglasses to reduce eye irritation from sun and wind exposure, and drink plenty of water to prevent becoming dehydrated and to maintain healthy tearing.

When to Contact Your Doctor

You should consult your family doctor or eye doctor if you are experiencing:

• Unexplained tearing over a long period
• Watery eyes that are also red and producing discharge
• Watery eyes and eye pain
• Watery eyes and sore sinuses

Your doctor will examine your eyes, perform tests on the quantity and quality of your tears, and look at how your eyes drain away tears. If you have an infection, the doctor can prescribe antibiotics or, if you have dry eyes or allergies, suggest other treatments.

In rare instances, surgery can be done to open blocked tear ducts. The surgeon can create a new tear duct in your eye through a procedure called dacryocystorhinostomy (DCR). For a tear duct that has narrowed but is not fully blocked, the surgeon can widen it with a small probe.

Ectropion can be corrected by tightening the muscles that hold the eyelid in place. This outpatient procedure can be done using local anesthesia.

Related Symptoms That May Accompany Watery Eyes

• Runny nose and sneezing. These symptoms along with watery eyes may be due to allergies.
• Epiphora. If it occurs along with symptoms of a sinus infection or head cold, it may be due to a blocked tear duct.
• Excessive tearing, blepharitis, and conjunctivitis. When these symptoms occur in an older person, they may be due to ectropion.
• Dry eyes along with bulging of the eyes. This may be a sign of overactive thyroid disease.
• Dry eyes along with changes in vision and arthritis. These symptoms together may be signs of KCS.

The bottom line? If your watery eyes don’t clear up with over-the-counter treatment, you should get medical attention to make you more comfortable.