Epiphora (excessive tearing)

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Last updated 9/25/2023
Woman with blocked tear duct

What causes epiphora (watery eyes)?

Epiphora is the medical term for watery eyes, which happens when tears are produced too rapidly or can't drain away properly.

 

Epiphora can occur at any age, and while it may be a nuisance, it's typically not a threat to vision. However, understanding its causes and getting appropriate treatment can significantly improve your comfort and quality of life. It can affect one or both eyes

What are the main causes of watery eyes?

 

  • Blocked tear ducts: the most common cause of watering eyes in adults is blocked tear ducts. When tears can’t drain away from the eyes properly, they build up and overflow onto the cheek.
  • Irritated by a foreign body object(s) in the eye
  • Chemical irritants or allergies can lead to excessive tear production
  • Ingrown eyelash (trichiasis)
  • Eyelid problems or eyelid malposition, such as lids that don't close fully or are improperly positioned, can lead to epiphora by disrupting the normal spread and drainage of tears.
  • Dry eye syndrome: when the eyes are dry, they may produce reflex tears, which are more watery and less effective at lubricating the eye. They can overflow and cause watering of the eyes.
  • Styes or chalazion
  • A scratched cornea or a corneal disease
  • Infections like pink eye (conjunctivitis) 

 

How does epiphora affect you?

Aside from having watery eyes, you may also suffer from the following:

 

  • Red eyes
  • Eye pain
  • Itchiness
  • Cloudy vision
  • Sinus headaches

 

How is the cause of epiphora diagnosed?

Our ophthalmologist will examine your eyes and both upper and lower eyelids. They may apply colored eye drops in your eyes to monitor their drainage. Normally, your tears would quickly flush out these drops and their dye. However, if the color persists, it could indicate a potential blockage in your tear duct.

 

Schedule your consultation with the internationally recognized doctors at Assil Gaur Eye Institute

 

How is epiphora treated?

The approach to managing epiphora varies based on the underlying cause. In instances where epiphora is mild, treatment may not be required as the condition often resolves by itself.

 

Medication

If the cause is dry eyes, inflammation (blepharitis), or allergies, our ophthalmologist will likely prescribe medication. For example, artificial tears or prescription eye drops may be recommended if you have dry eye. If a stye causes the inflammation of the eyelid, our eye specialist might instruct you to apply warm compresses to your eye.

 

Removing foreign objects

If a foreign object has entered your eye or if your eye has been injured in some way, our healthcare provider will work to remove the object or treat any inflicted damage.

 

Clearing blocked tear ducts

In the case of a blockage, our doctor might need to open up a blocked tear duct using a small probe and flush it out to clear any obstruction. This procedure is usually done under local anesthesia.

 

Repairing eyelids 

Suppose the cause of your tear overflow is a functional problem like an eyelid deformity or weak eye closure. In that case, our eye doctor may recommend a surgical correction to restore proper eye closure and tear drainage.

 

Why Choose Assil Gaur Eye Institute for your epiphora treatment? 

Your eyes are one of the most delicate structures in your body. That’s why, when you’re looking for a Los Angeles area surgeon to correct the appearance or function of your eyelids and the structures surrounding your eyes, you want to seek an oculoplastic surgeon.

 

As a trained ophthalmologist with a sub-specialty in oculoplastic surgery, Dr. Adeleh Yarmohammadi (known as "Dr. Adele" and Dr. Rafi Israel can thoroughly examine your eyes, understand any underlying eye disease, and identify potential problems that might impact the surgical plan -- things that even a board-certified facial plastic surgeon is not trained to do.

 

Our specialists have decades of combined experience treating functional eye problems affecting patients’ vision and health. He has performed thousands of cosmetic procedures, including revisions of surgeries performed elsewhere with unsatisfactory outcomes.

 

Among the conditions that AGEI treats are excess eyelid skin or fat, drooping eyelids, wrinkles around the eyes, eyelid reconstruction after tumor removal or eye injuries, excessive tearing, revising prior unsatisfactory eyelid surgeries, and abnormally turned in (entropion) or turned out (ectropion) lid margins.

 

Please schedule a consultation with us at our Beverly Hills or Santa Monica clinics to discuss the appearance or function of your eyelids. Please call 866-945-2745 or click here to request an appointment online.

 

Assil Gaur Eye Institute is conveniently located for patients throughout Southern California and the Los Angeles area in or near Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.

 

 

Epiphora FAQs

Epiphora FAQs

What is the difference between epiphora and lacrimation? 

Lacrimation is the process of producing tears. On the other hand, epiphora refers to the condition where there is an overflow of tears. 

 

So, you can think of lacrimation as the "making" of tears and epiphora as a "spilling over" of tears.

Can Bell's palsy cause epiphora?

Yes, Bell’s palsy can interfere with normal eyelid closure, leading to inadequate spreading and evaporation of tears. Consequently, the tear film may accumulate and overflow from the eye, leading to epiphora.

What is a dacryocystorhinostomy?

A dacryocystorhinostomy, often called a DCR, is a type of surgical procedure that creates a new pathway for tears to drain from the eye when the natural tear ducts are blocked. In this procedure, the surgeon makes a small hole in the bone between the eye and nose, connecting the lacrimal sac (the part of the tear duct system that collects tears) directly to the nasal cavity. 

 

This allows the tears to bypass the blocked part of the tear duct, relieving symptoms like watery eyes or infections that can occur when tears can't drain properly. The surgery is usually performed under general anesthesia and can be done using traditional surgical techniques or less invasive endoscopic methods.

 

 

Sources

Perez, Y., et al. (2021). Nasolacrimal duct obstruction. https://www.ncbi.nlm.nih.gov/books/NBK532873/

 

"Handbook of Ocular Disease Management - Chronic Epiphora". Archived from the original on 2007-05-09 . Retrieved 2007-05-13 .

 

Jones LT. Conjunctivodacryocystorhinostomy. Am J Ophthalmol. 2018 Mar; 187 :xxxvi-xliv. [PubMed : 29502684 ]

 

Kashkouli MB, Beigi B, Murthy R, Astbury N. Acquired external punctal stenosis: Etiology and associated findings. Am J Ophthalmol 2003:136:1079-84.

 

W. N. Offutt IV and D. E. Cowen, “Stenotic puncta: microsurgical punctoplasty,” Ophthalmic Plastic & Reconstructive Surgery, vol. 9, no. 3, pp. 201–205, 1993

 

Shimazaki, M. Sakala, and K. Tsubota, “Ocular surface changes and discomfort in patients with meibomian gland dysfunction,” Archives of Ophthalmology, vol. 113, no. 10, pp. 1266–1270, 1995.View at: Publisher Site | Google Scholar

 

Kashkonli MB, Rezaee R, Nilforonshan N, et al. Topical antiglaucoma medications and lacrimal drainage system obstruction. Ophthal Plast Reconstr Surg. 2008 May-Jun. 24(3):175-6.

 

Sumalee Vangveeravong. Microbiology of Primary Acquired Nasolacrimal duct obstruction: Simple Epiphora, Acute Dacryocystitis and Chronic Dacryocystitis. Clinical Ophthalmology. 2016 Feb 2022. 10:337-342.

 

Munk PL, Lin DT, Morris DC. Epiphora: treatment by means of dacryocystoplasty with balloon dilation of the nasolacrimal drainage apparatus. Radiology. 1990;177:687–90.

 

Williams B, et al. (2014). Patterns and causes of epiphora referrals to a tertiary oculoplastic practice. DOI: 10.1016/j.jcjo.2013.12.003

 

Esmer O, Karadag R, Soylu E, Oner AF, Burakgazi-Dalkilic E. Nasolacrimal system obstruction, ptosis and esotropia due to chemotherapy in acute lymphoblastic leukemia. Cutan Ocul Toxicol. 2013 

 

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