Tears help your eyes stay healthy and comfortable. However, uncontrolled tearing or watery eyes can impact your well-being and daily life.
Epiphora — more commonly referred to as watery eyes — is when you have excessive tear production. This can happen for a number of reasons. Your doctor can diagnose the cause, but let’s take a closer look at some of the possibilities.
Epiphora can cause your eyes to water slightly, or excessively with a constant stream of tears. You may also experience other symptoms in your eyes, such as:
- enlarged, visible blood vessels
- sharp pain
- eyelid swelling
- blurred vision
- light sensitivity
Foreign objects and injury
When you get something in your eye, the resulting irritation can trigger sudden blinking and watering to flush it out. A speck of dust, dirt, or other material may cause an abrasion or scratch. A dirty or torn contact lens can also scratch or injure the eye, leading to epiphora. You may also feel grittiness, pain, or discomfort in your eye.
Hay fever or allergic rhinitis is a common cause of epiphora. This happens when your body reacts to harmless substances such as pollen, dust, and pet dander. Your immune system makes antibodies to these allergens, triggering an inflammatory response that causes red, swollen, and watery eyes.
Infection and inflammation
Infections and inflammation of the eyes and eyelids can cause epiphora.
- Pink eye (conjunctivitis) is a common condition. It’s typically caused by a bacterial or viral infection in one or both eyes. As its name suggests, this condition causes inflamed blood vessels in the eye, giving it a pink or red look.
- The cornea, the clear lens of your eye, can become inflamed. This condition is called keratitis. Symptoms include pain, redness, blurred vision, sensitivity to light, and excess tearing and white discharge.
- An infection or inflammation in the lacrimal or tear glands can cause swelling and excess tearing.
- An ingrown eyelash can become infected causing painful swelling and watery eyes.
- A stye looks like a pimple or boil along the lash line. This painful red bump is usually caused by a bacterial infection of oil glands in the eyelid. Similarly, a chalazion is a smaller bump along the edge or underside of the eyelid that is not painful.
- Blepharitis is a red, inflamed swelling of the eyelids. This condition happens when the oil glands at the base of the eyelashes become clogged.
- Trachoma is a serious bacterial infection of the eye. This contagious condition is the leading cause of blindness in the world. Symptoms include itching, swollen eyelids, pus, and epiphora.
Tear duct obstruction
The nasolacrimal ducts are the tear ducts at the inside corner of each eye. They drain away tears to prevent the buildup of water in the eyes. These ducts can become blocked or narrowed, causing severe epiphora. This can affect one or both eyes. This condition affects babies, children, and adults.
The ducts can become blocked due to swelling, inflammation, and infection. Symptoms include eye swelling, redness, and tears that flow down the face.
Some types of obstructions are genetic. Punctal stenosis is a condition where the opening of the eye duct is narrowed or blocked.
Blinking your eyelids helps to evenly sweep tears on your eyes. Any changes in the structure and function of the eyelids can cause epiphora.
This may happen naturally or due to injury. Thinned and wrinkled eyelids in older adults can accumulate tears, causing redness and chronic watering.
An ectropic eyelid pulls away from the eyeball. This prevents tears from draining properly. An entropion eyelid is turned inwards. This can cause pressure, scraping, and discomfort in the eye, triggering epiphora.
A number of other conditions can cause epiphora, including:
- dry eyes
- cold and flu
- sun and wind
- excess use of digital devices
- injury to the face
- injury to the nose
- sinus infection
Some medications may also cause epiphora:
- topical blood pressure drugs
- chemotherapy drugs (taxane)
- eye drops (echothiophate iodide and pilocarpine)
Your doctor or eye specialist will examine your eyes and both upper and lower eyelids to find the cause of the epiphora. A scope lets your doctor see the blood vessels behind your eye and check eye pressure. Your nose passages and sinus cavities may also be examined. Your doctor will look at your symptoms and medical history.
If you have any discharge or pus from your eye, it may be tested to find out if you have a bacterial or viral infection.
Another test checks the chemical makeup of your tears. One clinical study found that people with epiphora had a lower number of particles in their tears.
Watery eyes may clear up without treatment. When necessary, treatment depends on the cause:
Flush out the object with a gentle stream of clean water. Wash your hands with soap and water and remove contact lenses if you’re wearing them. See your doctor if you still have watering, pain, or any other symptom after the object is removed.
Epiphora due to allergies is usually seasonal. Avoid known allergen triggers — such as pollen — during the spring months.
Relieve watery eyes and other allergy symptoms with medications. Allergy medications help to reduce an overactive immune response and ease symptoms. These include:
Infections and inflammation
Most viral eye infections clear up without treatment. Your doctor may treat a bacterial infection of the eye or eyelid with antibiotic drops or ointments.
Use a warm compress to soothe swelling and rinse the eye with sterile water to remove any crusting or discharge.
Blocked ducts and eyelid changes
Blocked tear ducts may clear up on their own or with antibiotic treatment for an eye infection. Use a warm compress with sterile water to help clear up any debris in the eyes.
In some cases, a blocked tear duct is treated with surgery to open up eye drainage. Eyelid changes may also be repaired with surgery.
A clinical trial found that injecting botulinum toxin may help to relax the muscles that close the tear ducts and treat epiphora.
Epiphora in newborn babies typically resolves on its own. Infant tear ducts can take up to a few months to fully open. You may need to clean the eyes with sterile wet cotton several times a day.
Watery eyes are common at any age. This condition is not always a cause for concern. Epiphora due to allergies, a cold, or an eyelid stye usually resolves on its own.
However, epiphora can also be a symptom of a serious infection. See your doctor urgently if you have epiphora along with pain, changes in vision, or a gritty sensation in your eyes.
Wash your hands regularly. Avoid touching your face to prevent spreading germs to your eyes.
If you wear contact lenses, you may be at higher risk of eye infections that lead to epiphora. Remember to wash your hands thoroughly before placing or removing lenses. Clean lenses daily. Replace old or expired contact lenses.
Protect your eyes and sight and help prevent epiphora with small, consistent changes. Wear sun protection when you’re outside. Reduce eye strain by wearing protective glasses and limiting your time looking at screens. Make complete eye exams a part of your regular health checkups.