Understanding Watery Eyes
Watery, tearing eyes are one of the most common annoyances that patients complain about when they come in for a check-up. It’s particularly more common in the months where allergies are the cause, so Spring and Autumn’s months have the most trouble. To know about this problem and how to manage it, you need to understand the plumbing around your eyes.
It really is just like a plumbing problem because your eyes make water, the tears, and they wash the surface of your eye and then drain down into your nose. At least, that’s the idea for how it works. But just like your kitchen sink, you can have problems with overflowing water if the drain blocks up or if there is too much water coming in for the drain to handle. So, let’s look at how this can happen with your eyes.
How Tears and Drains Work
There is a gland that makes the watery tears up under the outside corner of your eyelids, mostly behind the bone there. The water washes over your eyeball, and your blinking eyelids wipe it over the surface of your eye just like the windshield wipers of your car. There is a tiny drain in the inside corner of each of your eyelids that drains the tears into your nose. That’s why when you cry, your nose runs. If you like to know the names of things, the gland is called the Lacrimal Gland. The opening of the drain is called the Punctum. And the drain itself is called the Nasolacrimal Duct.
It’s a good system to lubricate your eyes. What could go wrong!?
Common Causes of Teary Eyes
Start with the gland making too much fluid. That happens with lots of issues. Emotions would certainly be a common one. You’re sad, and you cry. Too many tears overwhelm the drain. If you get something in your eye that causes irritation, and the gland makes lots of water to wash off the surface. That also includes things you are allergic to. The clue to diagnosing these is that emotions cause tearing in both eyes. Irritation may only be in the eye that gets irritated, and allergies would be in both eyes if it’s environmental and in just one eye if that gets something you’re allergic to in just one eye. Solving these problems is mostly common sense. If you’re sad, get over it, and your crying stops! If you get something in your eye, wash it out, wear eye protection, and don’t get things into your eyes that irritate them. If something is stuck in your eye, you need to have an eye doctor examine and remove it before it causes any damage.
Allergies
Allergies are sometimes more difficult to fix. If it’s something in the air like pollen, mold, or fumes, you may not be able to avoid it easily. Air cleaners in the home or workplace can help. There are some very good medications, over-the-counter, to reduce tearing with ocular allergies. They are generally safe to use and can be very effective. But you do have to use them regularly to avoid tearing.
Nasal Congestion
The other common problem caused by allergies is nasal congestion. Remember, the tears go through a drain into your nose. Well, if there is mucus congestion blocking the drain inside your nose, the tears can’t get down the drain and instead will roll down your cheek. This is often fixed by using nasal sprays to dry up the mucus congestion. That will relieve the blockage of the tear drain and end the tearing problem. So fixing a nose problem can solve an eye problem!
Other Potential Blockages
Other things can block the tear drainage channel. Some doctors put plugs in the drain to keep the tears in your eyes in patients with Dry Eye Disease. If your eyes are not that dry, the tears will roll down your cheek. Like other tubes and drains in your body, you can get stone formations in the nasolacrimal duct, just like gallstones or kidney stones. These can block the drain and cause tearing that nasal spray won’t help. Sometimes you can have enough blockage from chronic allergy or nose injuries that the drain is actually scarred shut. That takes surgery to reopen the drain or create a new one to stop the tearing.
Dry Eye Misconceptions
The last thing that seems so confusing to a lot of people is when you read that “your eyes are watering because you have dry eye disease.” Who believes that too much dryness causes too much watering? What is correct to say is that your eyes need lubrication along with moisture. So, there are glands along the edge of your eyelids that make oil to lubricate your eyes. These are different from the lacrimal gland that makes watery tears to provide moisture.
Seeking Out an Eye Specialist
If the eyelid oil glands are blocked, your eye does not have the needed lubrication and gets irritated. That causes the lacrimal gland to try and make more tears to wash away the irritation as noted above. But the irritation comes from too little oil lubricating your eye, and that is also referred to as Dry Eye Disease, even though there is no actual dryness. The oil glands can be cleaned out to restore the lubrication your eye needs and thus stop the watering. Or you can use artificial tears that have an oily component to replace the lubrication your own glands can’t provide.
It is best to have your eye doctor check to see the cause of your tearing problem and provide you with the best advice to solve this effectively. At the Dry Eye Institute, we have specialists with the most advanced diagnostic equipment to correctly diagnose, measure and treat your watery eye problems. Please call us to set up a visit.
Lawrence A. Gans, MD, FACS
Medical Director