Tears are produced by the lacrimal glands and lubricate the eye surface before draining into the inner corner of the eye into a duct, the naso-lacrimal duct, which opens in the nose. Watering or tearing of the eye can be caused either by an increased production of tears or a blockage in the drainage of tears.
Some of the common causes of tearing include blepharitis, dry eye, eyelid malposition, naso-lacrimal duct obstruction (NLDO) and injury to the lacrimal or tear drainage system.
Blepharitis means an inflammation of the eyelids. Our eyelids contain oil-producing glands that contribute to tear formation. Inflammation of the eyelids leads to clogging of these pores, which leads to abnormal tear formation causing them to evaporate faster than usually. This causes a dry, gritty sensation in the eyes which produces a reflex overproduction of tears causing watering. Treatment for this includes treating the underlying cause of blepharitis.
Normal eyelid position contributes to the function of the eyelid in draining the tears to the inner part of the eye. Any change or malposition of the eyelid leads to a defect in the normal drainage of tears, leading to watering. To know more about eyelid malposition, click here.
Blockage of the tear duct can lead to excessive tearing too. This can occur as a birth defect or develop in adulthood. In cases where the tear duct is blocked at birth, it opens spontaneously in about 80% infants by one year of age.
A massage of the lacrimal sac (the area near the nose on the lower eyelid) is advised to improve the flow of tears and expedite the opening of the duct. If the block is persistent beyond one year of age, probing of the duct is advised. Other steps like placement of silicone tubes or surgery may be advised in case primary probing is not successful.
Duct obstruction that develops in adulthood presents with persistent watering with tears running down the face, occasionally with yellowish discharge. Assessment of this condition requires testing the patency of the duct by flushing fluid through the drainage system. Once the diagnosis of NLDO is confirmed, the best course of treatment is to proceed with dacryocystorhinostomy or DCR surgery. This surgery aims to bypass the blocked tear duct and create a new tear drainage pathway. It can be performed externally ( with an incision between the lower eyelid and the nose) or endoscopically ( using an endoscope to perform the procedure through the nose, with no external incisions).
Contact our team to know more about scheduling a consultation for watering eyes.
Vaikunth Eye Clinic 528, 5th Floor, Gala Empire, Drive In Rd, opp. Doordarshan Metro Station, Nilmani Society, Thaltej, Ahmedabad, Gujarat 380059
