What Causes Watering Eyes?
Watering eyes can be caused by a variety of problems.
- A problem with the glands of the eyelids called the meibomian glands. These glands normally secrete an oily substance that slows the evaporation of tears between blinks. When they do not function properly, a condition known as Meibomian Gland Dysfunction (MGD) can develop resulting in dry patches on the eyes. The eyes become sore producing extra tears as a result.
- The lower eyelid sagging away from the eye (an ectropion) making it difficult for tears to reach the drainage ducts.
- Eyelids that roll inwards (an entropion).
- Narrowed or blocked tear ducts.
- Inflammation of the edges of the eyelids (Blepharitis).
- An eye infection, such as conjunctivitis.
- An eye allergy.
In newborn babies the tear draining tube normally opens into the nose. In some babies there is a delay in the normal development and opening of the tear duct and a membrane persists at the lower end of the tube preventing tears from draining into the nose.
Who It Affects
The problem can affect anyone but it is most common in young babies and in the elderly.
Symptoms of Watering Eyes
Apart from the watering, this condition can cause blurring of vision, sore eyelids and sticky eyes. An infection can result in a watery and pussy discharge from the eye.
Treatment of Watering Eyes
In babies, where the tear duct has not opened the treatment involves passing a probe down the drainage tube and breaking through the membrane. This is a simple procedure which requires a general anaesthetic. In many cases the tear duct will open spontaneously in the first year of life and unless the child is having repeated infections it is sensible to delay the procedure until the child is a year old.
Depending on the cause there can be a variety of treatments from the use of topical antibiotics in the form of eye ointments to:
Surgical repair to re-appose the eyelid and tear duct opening.
When the eyelid (usually the lower eyelid) turns inwards the eyelashes rub on the cornea. When this is caused by temporary muscle spasm it can be relieved by taping the lid down or the use of Botox injections but more often the entropion is due to age related changes in which case it requires a fairly simple surgical procedure done under local anaesthesia.
Narrowed or blocked tear ducts
Where the problem is due to a narrowed tear duct opening, simple dilatation may be all that is required, however if the tear duct itself , or its opening into the nose is blocked it is usually necessary to bypass the obstruction by means of a surgical procedure (a dacryocystorhinostomy) which usually requires a general anaesthetic.
Your GP may find a condition such as conjunctivitis which can be treated without further investigation. It may be necessary to be referred to an eye specialist for further examination and treatment.
When the watering is due to MGD, the cause must be discovered. Unfortunately when the oily layer is deficient because of MGD, the tear film becomes unstable and produces dry eye symptoms even though the watery component of the tears is NOT deficient. For this reason patients are often treated with tear supplements even though the problem is actually due to deficiency of the oily layer. MGD is most often due to meibomianitis (inflammation of the meibomian glands). Eradication of meibomian gland inflammation can be difficult and involves meticulous cleaning of the eyelid margins as follows:
After the application of heat to the eyelids for 2 or 3 minutes (best done by holding a flannel which has been soaked in hot water against the eyelids) to soften any deposits, a cotton bud which has been dipped in dilute “baby” shampoo (3 or 4 drops to an egg cup of water) is rubbed along the eyelid margins. This should be followed by the application of an antibiotic.
Allergy. The itching, redness burning and watering can be avoided if the allergen responsible can be identified and avoided. This is often not possible and the help of an allergist may be required. Antihistamine and mast cell stabiliser eye drops are usually prescribed with good effect. With more serious eye allergies steroid eye drops may be necessary. These should be managed by an eye specialist.
In summary medication may be needed if the cause of watering is an infection or allergy, and surgery may be needed if a tear duct is blocked. If the watering is not interfering with everyday life treatment may not be necessary.
You can reduce or ease symptoms by avoiding the use of contact lenses and smoky environments.
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- Watering Eyes: http://www.nhs.uk/conditions/watering-eye/Pages/Introduction.aspx
- Treating Watery Eyes: http://www.nhs.uk/Conditions/Watering-eye/Pages/Treatment.aspx