What is Tearing?
Tearing occurs for one of two reasons:
- The tear drainage system is not properly functioning.
- The eye is producing more tears than needed.
The lacrimal gland and accessory lacrimal glands produce the tears that coat the front of the eye. As we blink, the eyelids spread the tears across the eye’s surface, and push them toward the lower inner corner of the eye. The tears then drain through the lacrimal system into the nasolacrimal duct, which connects the eyes to the nose. Tears will enter the nasolacrimal duct and then travel down the nose into the throat.
What are Symptoms of Tearing Eyes?
Patients may have many symptoms from tearing eyes, and this may include foreign body sensation, itchiness, burning, swelling of the eyelids, redness, discharge, crusting, or even decrease in visual acuity.
What are Causes of Tearing Eyes?
Tearing can result from two reasons:
1) There is a blockage of the nasal-lacrimal drainage system.
2) There is excess tear production.
Causes of increased tear production, or watery eyes include dry eye syndrome with reflex tearing, conjunctivitis, blepharitis, allergies, and malposition of the eyelids. Patients with dry eyes may actually have eye discomfort, which triggers the reflex resulting in production of tears.
How are Watery Eyes Diagnosed?
At the Mack Center, an in-depth history will be obtained to diagnose the etiology of watery eyes, including your medical history, lifestyle, and signs & symptoms. A thorough eye exam will be performed, including assessment of the cornea, testing of the amount of tear production, and testing of the drainage of the nasolacrimal system. A combination of all of these tests will result in the determination of the watery eyes, and the subsequent treatment will be tailored to each patient.
What is the Treatment for Watery Eyes?
The treatment for watery eyes depends on the multiple etiologies. One of the most common is secondary to dry eyes with a reflex tearing which results in the excess tear production. The treatment for these patients may require artificial tears, artificial lubricating ointments, and possibly placement of punctal plugs to decrease the drainage of the tears. Patients with allergies may be treated with topical anti-allergy drops. Patients with lacrimal blockage may require surgical intervention for their treatment, which is performed on an outpatient basis at an outpatient surgery center under IV (MAC) anesthesia. Patients who present with eyelids that are turned inward (entropion) or outward (ectropion) will require surgical intervention to reposition the eyelids to the correct anatomical position to allow both protection of the eye and also to allow proper movement of the eyelid to spread the tears across the surface of the eye. Patients who present with conjunctivitis may require topical antibiotics for treatment. Additionally, patients who present with blepharitis may require warm compresses and scrubs as part of their treatment regimen.
What is the Prognosis for Patients Who Present with Watery Eyes?
Usually, the prognosis for patients who present with watery or tearing eyes at the Mack Center is very good. The most important step is to perform a complete history and examination to determine the etiology of the watery or tearing eyes, and then to subsequently tailor the treatment to treat the particular problem. Patients with allergies may respond very quickly to anti-allergy drugs, whereas patients with dry eye syndrome may require a longer treatment period to reestablish the proper lubrication of the eyes. Patients with tear drop duct obstruction or eyelid malposition will require outpatient surgery, which is performed under MAC anesthesia with IV sedation, which our patients find to be a pain-free experience. Once the correct diagnosis of the etiology has been made, patients have an excellent prognosis for the treatment of watering or tearing eyes at the Mack Center.
For more information on Tampa Tearing Problems, contact Dr. Mack’s office to schedule a consultation today.