How to Stop Watery Eyes: Causes, Treatments, and the Best Remedies for Tear Management

Hello, everyone! Dr. Joseph Allen here from the Dr. Eye Health show, where we dive into everything about eye care to help you maintain healthy eyes and clear vision. In today’s video, I’m going to address a common yet frustrating issue: watery eyes. We’ll explore what causes frequent tearing, discuss the potential underlying conditions, and share with you the most effective remedy I use in my clinic to manage and treat watery eyes. Let’s get started!

Why Do My Eyes Water? The Basics

If you’ve ever dealt with constantly watery eyes, you know how bothersome it can be. Whether it’s both eyes or just one, the sensation of tears constantly flowing down your face is not only uncomfortable but can also be socially awkward. People might ask if you’re upset, or why your face is always wet. It’s a condition that can significantly affect your daily life.

You might be surprised to learn that when you visit an eye doctor for watery eyes, they might tell you that your eyes are actually dry. This might seem counterintuitive—after all, your eyes are producing more tears, not less! However, dry eye syndrome is a complex condition where the eye's surface isn’t properly lubricated, causing your eyes to respond by producing excess tears as a compensatory mechanism. But that’s not the whole story. There are several other reasons why your eyes might be watering, and understanding these causes is key to finding the right solution.

The Most Common Cause: Blocked Tear Ducts

One of the first things I investigate in patients with watery eyes is the possibility of a blocked tear duct. The tear duct system, also known as the nasolacrimal drainage system, plays a crucial role in managing the tears your eyes produce. Here’s how it works:

Tears are produced by the lacrimal glands, located just above the outer corner of each eye. These tears serve to lubricate the eye, keeping it moist and free of dust or debris. When you blink, your eyelids spread the tears across the surface of your eye. The excess tears then drain through tiny openings called puncta, located in the inner corners of your upper and lower eyelids.

From the puncta, tears flow into the nasolacrimal ducts, which carry the tears into the nasal cavity. This is why your nose tends to run when you cry—those tears are draining through your nose! But if there’s a blockage anywhere along this drainage pathway, the tears can’t drain properly. Instead, they build up on the surface of the eye and overflow down your face.

Causes of Blocked Tear Ducts

Blockages in the tear duct system can occur for various reasons, and they can affect people of all ages. Some common causes include:

• Aging: As we age, the tissues around the tear ducts can lose elasticity, leading to a narrowing or closure of the ducts.

• Medical Treatments: Certain treatments, such as radiotherapy or chemotherapy, can cause scarring or inflammation in the tear ducts, leading to blockages.

• Eye Medications: Some eye drops, particularly those used to treat glaucoma, can cause changes in the tear duct system that lead to blockages.

• Inflammation: Conditions like blepharitis (inflammation of the eyelids) or conjunctivitis (inflammation of the eye’s surface) can cause swelling and block the tear ducts.

• Infections: An infection in the tear duct system, known as dacryocystitis, can cause swelling and blockage, often leading to pain and redness near the inner corner of the eye. In some cases, the infection can lead to the formation of dacryoliths, which are small calcium deposits that obstruct the tear ducts.

• Dry Eye Syndrome: Although it may seem contradictory, dry eyes can also contribute to blocked tear ducts. When the surface of the eye is too dry, the body may overproduce tears to compensate, but these tears may not flow properly if the ducts are blocked.

Diagnosing a Blocked Tear Duct

If you’re experiencing persistent watery eyes, an eye doctor can perform several tests to determine whether a blocked tear duct is the cause. One common test is the Jones test, where the doctor places a small amount of fluorescein dye into the lower eyelid. The dye helps to visualize the tear drainage and allows the doctor to monitor how quickly the tears drain away.

If the dye doesn’t drain properly, it could indicate a blockage. Another test, called dilation and irrigation, involves flushing the tear duct system with a saline solution to check for blockages. During this procedure, a tiny tube is inserted into the puncta, and the saline is gently pushed through the tear ducts. If there’s a blockage, the saline may help to clear it, and you might even taste the saline in the back of your throat as it drains through your nasal cavity.

In many cases, this simple procedure can resolve the issue, and patients often experience immediate relief. It’s always rewarding to see how grateful patients are after having this procedure, especially if they’ve been dealing with watery eyes for a long time without knowing the cause.

When Surgery Is Necessary

While dilation and irrigation can clear many blockages, some cases require more invasive intervention. If the blockage is severe or if it recurs after treatment, surgery may be necessary to create a new drainage pathway or remove the obstruction. This procedure, known as dacryocystorhinostomy (DCR), involves creating a new opening between the tear sac and the nasal cavity to bypass the blocked duct. Although surgery might sound daunting, it’s a highly effective treatment for persistent tear duct blockages and can significantly improve quality of life for patients with chronic watery eyes.

Other Causes of Watery Eyes: Ectropion and Conjunctivochalasis

In addition to blocked tear ducts, other structural issues with the eyelids can lead to watery eyes. Two common conditions are ectropion and conjunctivochalasis.

• Ectropion: Ectropion is a condition where the lower eyelid turns outward, away from the eye. This can happen as a result of aging, injury, or previous eye surgery. When the eyelid is no longer in contact with the eye, tears can’t be properly siphoned into the puncta for drainage. Instead, they pool in the eye and spill over the edge of the eyelid, leading to constant tearing. Mild cases of ectropion might be managed with lubricating eye drops or ointments, but more severe cases often require surgical correction to reposition the eyelid.

• Conjunctivochalasis: Conjunctivochalasis is a condition where the conjunctiva—the clear membrane covering the white part of the eye—becomes loose and wrinkled. This redundant tissue can bunch up and block the puncta, preventing tears from draining properly. In some cases, the conjunctiva can even cover the lower eyelid, further obstructing tear flow. Conjunctivochalasis is often associated with chronic inflammation, dry eyes, or previous eye surgery. Treatment typically starts with anti-inflammatory eye drops or ointments to reduce swelling and improve tear flow. However, if conservative treatments don’t work, surgery may be needed to remove the excess tissue and restore proper drainage.

Allergies: A Common Culprit

Another frequent cause of watery eyes is allergies. If your eyes are watery during certain times of the year—especially in the spring or fall—seasonal allergies could be to blame. When your body encounters allergens like pollen, dust, or pet dander, it releases histamines to fight off these invaders. This immune response can cause your eyes to become red, itchy, and swollen, leading to increased tear production as your body tries to flush out the allergens.

In addition to watery eyes, allergies often come with other symptoms, such as a runny nose, sneezing, sinus congestion, or difficulty breathing. If you suspect that allergies are causing your watery eyes, there are several over-the-counter treatments available that can help.

• Over-the-Counter Eye Drops: Two effective options for treating eye allergies are Pataday and Lastacaft. Both of these eye drops contain antihistamines that reduce itching and inflammation, and they’re available without a prescription. These drops can be used once a day and are highly effective for most people, providing relief from symptoms within minutes.

• Cold Compresses: Applying a cold compress to your eyes can help reduce swelling and soothe irritation, providing temporary relief from allergy symptoms.

• Artificial Tears: Lubricating eye drops, also known as artificial tears, can help wash away allergens from the surface of your eyes and provide soothing moisture.

Dry Eye Syndrome: The Counterintuitive Cause

Finally, we need to talk about dry eye syndrome—a condition that might seem like the opposite of watery eyes, but can actually be a contributing factor. Dry eye syndrome occurs when your eyes don’t produce enough tears, or when the tears you do produce aren’t of the right consistency to keep your eyes properly lubricated. This can lead to chronic dryness, irritation, and, paradoxically, excess tear production.

When your eyes are dry, the surface of the eye can become inflamed and irritated. In response, your body may try to compensate by producing more tears. However, these tears are often of poor quality and don’t stick to the surface of the eye, leading to a cycle of dryness and excess tearing.

Managing Dry Eye Syndrome

If dry eye syndrome is contributing to your watery eyes, there are several strategies you can try to manage the condition:

• Artificial Tears: Using lubricating eye drops throughout the day can help keep your eyes moist and prevent the cycle of dryness and excess tearing.

• Stay Hydrated: Drinking plenty of water can help maintain moisture levels in your body and support healthy tear production. Dehydration can exacerbate dry eye symptoms, so it’s important to stay well-hydrated, especially in dry or windy environments.

• Use a Humidifier: Adding moisture to the air with a humidifier can help prevent your eyes from drying out, especially in environments with low humidity, like heated or air-conditioned rooms.

• Take Frequent Breaks: If you spend long hours in front of a computer or screen, take frequent breaks to rest your eyes. Follow the 20-20-20 rule: every 20 minutes, look at something 20 feet away for at least 20 seconds. This helps reduce eye strain and encourages normal blinking, which can improve tear film stability.

• Omega-3 Fatty Acids: Incorporating omega-3 fatty acids into your diet, through foods like fish or flaxseed, or as supplements, has been shown to improve the quality of tears and reduce inflammation associated with dry eye syndrome.

• Warm Compresses and Lid Hygiene: Applying a warm compress to your eyes can help to loosen any blocked oil glands and improve the quality of your tear film. Regular eyelid hygiene, such as gently cleaning your eyelids with a mild cleanser or using pre-moistened eyelid wipes, can also help manage dry eye symptoms, especially if blepharitis is present.

• Prescription Medications: In some cases, your doctor might prescribe medications to help manage chronic dry eye. These can include anti-inflammatory eye drops like cyclosporine (Restasis) or lifitegrast (Xiidra), which reduce inflammation and increase tear production over time.

Other Medical Conditions That Can Cause Watery Eyes

In addition to the more common causes of watery eyes, there are several other medical conditions that can lead to increased tear production or obstruct tear drainage. Some of these include:

• Bell’s Palsy: This condition causes temporary weakness or paralysis of the muscles on one side of the face, including the muscles that control eyelid function. When the lower eyelid droops, it can lead to poor tear drainage and watery eyes.

• Graves’ Disease: This autoimmune disorder affects the thyroid gland and can lead to eye symptoms, including bulging eyes (proptosis) and watery eyes. The condition causes inflammation of the eye muscles and tissues, leading to excessive tearing.

• Rosacea: Ocular rosacea is a subtype of rosacea that affects the eyes, causing redness, irritation, and sometimes watery eyes. The condition can also lead to eyelid inflammation and blockage of the oil glands, further contributing to dry eye symptoms.

• Sjogren’s Syndrome: This autoimmune condition primarily affects the glands that produce moisture, including the tear and salivary glands. It can lead to severe dry eyes, which paradoxically may result in increased tear production as the body tries to compensate.

• Infections and Irritants: Infections like conjunctivitis (pink eye) or exposure to irritants like smoke, pollution, or chemicals can cause temporary inflammation and lead to watery eyes. In these cases, treating the underlying cause usually resolves the excessive tearing.

When to See a Doctor

While watery eyes are often a minor annoyance, they can sometimes be a sign of a more serious underlying condition, especially if they are accompanied by other symptoms such as pain, vision changes, or redness. If you experience persistent watery eyes that don’t improve with over-the-counter treatments, or if you have any concerning symptoms, it’s important to see an eye care professional for a comprehensive evaluation.

Your eye doctor can help determine the cause of your watery eyes and recommend appropriate treatment. Whether it’s something as simple as a blocked tear duct that can be easily flushed out, or a more complex condition that requires medical management, getting a proper diagnosis is the first step toward relief.

Effective Treatment for Watery Eyes: Personal Insight

As an eye doctor, I’ve seen countless patients with watery eyes, and one of the most effective treatments I’ve used in my clinic is punctal plugs. These tiny, biocompatible devices are inserted into the tear ducts to block them temporarily, which helps retain moisture on the surface of the eye and prevents excessive tearing.

Punctal plugs are often used for patients with dry eye syndrome, but they can also be effective for managing watery eyes caused by other factors. The procedure is quick and painless, and the plugs can be removed if needed. In many cases, patients experience immediate relief from their symptoms, and they’re thrilled to finally have a solution to their watery eyes.

Conclusion: Take Control of Your Watery Eyes

Watery eyes can be a frustrating and uncomfortable condition, but the good news is that there are many effective treatments available. Whether it’s addressing a blocked tear duct, managing dry eye syndrome, or treating underlying allergies or medical conditions, the key is to get a proper diagnosis and work with your eye care professional to find the right solution for you.

Remember, you don’t have to live with constantly watery eyes. By understanding the causes and exploring the available treatment options, you can take control of your symptoms and enjoy clear, comfortable vision once again.