According to a study in the American Journal of Ophthalmology, approximately 16 million people in the United States have been diagnosed with dry eye disease. The same study, though, estimates that about 33% of ophthalmology patients present with the symptoms of this condition. One of the most prevalent symptoms of dry eye disease is excessive tearing. Because it is such a common symptom, people who experience excessive tearing often believe, after a quick online search, that they have dry eye disease. This may not be the case. Here, we discuss some of the other reasons excessive tearing may occur and what you can do to improve this symptom.

Normal Tear Flow

The tear film is a vital part of the healthy eye. This film, made of oil, mucus, and water, is made in glands in the eye socket. When we blink, this film is spread over the ocular surface in the direction of the nose. There, at the inner corners of the upper and lower eyelids, are tiny drainage ducts that connect to the nose. Some tears naturally flow into the nose, then, when we blink. Some of the tear film also evaporates from the ocular surface. We all get dry eyes and excessive tearing from time to time, but when the condition is the norm, we want to know why. True understanding comes from looking beyond dry eye symptoms. 

Conditions that Could Cause Excessive Tearing

Blocked Tear Drainage Ducts

Remember we mentioned that tears flow toward the center of the eyes to tiny ducts that connect to the nose. One or both of these ducts could become blocked, preventing tears from draining normally into the nose. Common sources of tear duct blockage are infection, inflammation, certain medications, injury, previous sinus surgery, or, rarely, a tumor. Blockages in tear ducts can be partial or complete, and may result in not only watery eyes but also inflammation, irritation, and an increased risk of infection. 

Eyelid Problems

Once tears enter the ocular area, the muscles in the eyelids move the film toward the natural ductal system. Certain conditions affecting the eyelids may diminish this function. Ectropion is characterized by an outward turn of the lower eyelid. It is usually seen in older people and relates to the natural weakening of the tendons and muscles that control the lower eyelid and hold it against the globe of the eye (eyeball). Ectropion may also occur as a symptom of Bell’s palsy or other facial paralysis. Because the lower eyelid does not sit against the globe as it should, the glands that produce the tear film are triggered to reflex tearing to keep the eye lubricated. 

Loose eyelids do not always indicate ectropion. Some people develop extremely loose upper eyelids. Without sufficient firmness and strength, the eyelids open when the person sleeps. Symptoms of this condition, referred to as Floppy Eyelid Syndrome, may include waking up with scratchy, watery eyes. People with sleep apnea often experience this condition. 

Evaluation by your optometrist or ophthalmologist may be a good place to start uncovering the cause of excessive tearing. However, you may benefit most from a consultation with an oculofacial plastic surgery specialist, such as Dr. Fante. Here, patients can expect a comprehensive evaluation of the eyes and eyelids to determine the cause of watery eyes. 

Learn more about excessive tearing and how we treat it. Call (303) 839-1616 to schedule a consultation with Dr. Robert Fante or .

The eyes get watery sometimes, but the production of tears should not become a nuisance. The eyes typically make enough tears to keep the ocular surface moist, and they also have natural drainage tubes that clear old fluid out to make way for new tears. There are several reasons why tears may build up and cause excessively watery eyes. If you’re living with this condition that we refer to as Epiphora, you need to know there are solutions that can put a stop to this frustrating problem.

What Causes Watery Eyes?

The thing about watery eyes is that there is more than one potential cause. Therefore, there must be more than one available treatment option. To determine the most appropriate protocol for treating watery eyes, we must know what is causing them. This means we have to look at the tear film.

Ocular health relies heavily on a healthy tear film. Tears aren’t just for crying, they provide vital nutrients to the ocular surface and contain antibodies that help ward off infection. Tears originate in the lacrimal gland that is located deep within the tissue of the upper, outer eyelid. They have a fatty layer, an aqueous layer, and a mucus layer, each of which is present when the tear film leaves the gland. When tears leave the lacrimal gland, they are spread across the eye by blinking. They travel from the upper, outer region to the inner, lower region, where they can then exit the eye through the puncta and down through the nose.

What Causes Excessive Tearing?

We cannot assume that excessive tearing means that the lacrimal gland is simply over productive. There are several other causes to consider. It could be that the eyelids are inflamed or that there is a malposition of the eyelid. Either detail of the eye could disrupt the balance of the fatty layer of tears. Without sufficient oil, the tear film evaporates quickly, causing dry eye. When the ocular surface is intensely dry, the natural response is for the lacrimal gland to make more tears. Excessive watering resultant from dry eye syndrome may be a relatively easy fix using eye drops or innovative ophthalmic treatments to reduce eyelid inflammation.

Excessive tearing resultant of eyelid malposition may relate to entropion or ectropion. Entropion describes an inward turning of the eyelid margin. An inward turn can cause inflammation as the eyelashes rub against the ocular surface. Conversely, ectropion describes an outward turn. When the eyelid turns outward, there is no contact between the eyelid margin and the eye, which exposes the ocular surface to the environment. The natural reflex, then, is for the eye to water. Because the outward turn also disrupts the position of the punctum, the natural drainage system, tears also have nowhere to go. Eyelid malposition can often be corrected in an outpatient procedure.

Schedule a Consultation

We have discussed only a few of the potential causes of excessive tearing. To discover why your eyes are watering excessively, schedule a consultation in our Denver office. Call (303) 839-1616 for assistance.