Watery eyes or Epiphora


Watering eye, also known as epiphora or tearing, is a condition in which there is an overflow of tears onto the face, often without a clear explanation. There is insufficient tear film drainage from the eye(s) – instead of all the tears draining through the nasolacrimal system, they overflow onto the face.

Epiphora can develop at any age. It is, however, more common among babies aged under 12 months, and adults over the age of 60 years. The condition may present symptoms in just one or both eyes.

In most cases watering eye can be treated effectively. Depending on the severity of symptoms, watering eye can sometimes make driving difficult and dangerous.

Causes of watering eyes (epiphora)

There are two main causes of watering eyes – blocked tear ducts or excessive production of tears. Let’s look at each of these in turn.

In infants, persistent watery eyes, often with some matter, are commonly the result of blocked tear ducts. The tear ducts don’t produce tears, but rather carry away tears, similar to how a storm drain carries away rainwater. Tears normally drain into your nose through tiny openings (puncta) in the inner part of the lids near the nose. In babies, the tear duct may not be fully open and functioning for the first several months of life.

In older adults, persistent watery eyes may occur as the aging skin of the eyelids sags away from the eyeball, allowing tears to accumulate and flow out.

Sometimes, excess tear production may cause watery eyes as well.

Allergies or viral infections (conjunctivitis), as well as any kind of inflammation, may cause watery eyes for a few days or so.

Medication causes

  1. Chemotherapy drugs
  2. Epinephrine
  3. Eyedrops, especially echothiophate iodide and pilocarpine

Who gets watering eyes

Watering eyes (tears rolling on to your cheeks) can occur at any age, but are most common in young babies and in people over the age of 60. It can occur in one or both eyes.

What is the treatment for watering eyes?

Treating eye irritation

Quite often the cause can be treated. For example:

  • Eyelashes irritating the front of the eye (entropion) can be removed.
  • Conjunctivitis can usually be treated with drops.
  • Pieces of grit, etc, can be removed.

Treating tear drainage problems

  • Ectropion can usually be treated with a minor operation to the lower eyelid.
  • Babies with watery eyes usually grow out of it with no treatment.
  • Blockage of the channels in adults:
    • You may not need treatment if the watering is mild or does not bother you much.
    • A blocked tear duct can be treated with an operation. The usual operation is called dacrocystorhinostomy (DCR). In this operation a new passage is made between your tear sac and your nose and this bypasses any blockage below your tear sac and allows tears to drain normally again.
    • DCR surgery is worthwhile if the watering is bad enough to interfere with your activities of daily living. It is also recommended if you have had an infection in your tear sac as a result of the blocked tear duct. The surgery may prevent repeated attacks of a red, painful swelling at the corner of your eye.
    • There are two ways of doing this surgery, either externally – through your skin or endoscopically – from within your nostril. Your doctor will be able to give you more information regarding this.
    • A narrowed small channel (canaliculus) which is not fully blocked may be widened by pushing in a probe. However, if it is completely blocked, an operation is an option to drain the tears into the nose.