Q. I have extremely watery eyes that haven’t improved with prescription eyedrops. I’ve been to ophthalmologists and allergists without results. Is there anything that can be done for this problem?
–Prospect Heights, Ill.
A. Excessive tearing can by caused by several factors. You don’t mention whether your tearing is constant or episodic. There are different treatment approaches depending on which type it is.
Constant tearing: This can be a result of a blockage of the tear-drainage system. Also, changes due to aging can cause the lower eyelid to turn away from the eye, which can also cause poor drainage and tearing.
Your eye-care provider can irrigate the tear-drainage system to determine if a blockage is the cause of the tearing. If the tear duct is blocked, surgery can be performed to create a new drain. If poor lid positioning is causing the tearing, eyelid surgery can help.
Episodic tearing: This usually is associated with a poor or unstable tear film. Blepharitis, an inflammation of the eyelids, is a common cause. Blepharitis results in inflammation of the oil glands along the eyelid. The oil protects the tear film and prevents tears from evaporating too quickly. When the glands are inflamed and plugged up, the tear film breaks down. Your body’s natural reaction is to create a gush of tears, with episodes of tearing throughout the day.
Your doctor could prescribe a short course of anti-inflammatory eyedrops and/or oral medications to treat blepharitis, although it may become a chronic condition. Eyedrops and oral medications can be used in repeated cycles to treat flare-ups. Often, warm compresses with lid massage and artificial tears can help stabilize this condition, resulting in less frequent and intense flare-ups.
Visual tasks such as driving, reading or watching television make the tearing worse. Taking breaks from eye-straining activities and using artificial tears to replenish tears can help prevent episodic tearing.
Episodic tearing also can be caused by decreased tear production. When the eye is drying out, your reflex tearing mechanism fills the eye with tears.
Your eye-care provider can diagnose dry eyes by measuring tear production and looking at the eye with special stains. Treatment options include artificial tears and gels, plugs to block the drain to allow more tears to bathe the eye, and anti-inflammatory drops such as cyclosporine.
The key to treatment is to identify the cause of the watery eye and then address the underlying problem.
–Saiyid Hasan, M.D., Ophthalmology, Mayo Clinic, Jacksonville, Fla.
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