- Medically Reviewed by Mr Mfazo Hove Consultant Ophthalmologist
- Author: Chris Dunnington
- Published: November 7, 2024
At Blue Fin Vision®, our premier eye clinic in London, we often encounter patients concerned about excessively watery eyes. If you’ve found yourself asking, “Why do my eyes keep watering?” or “Why is only one eye watering?”, you’re not alone. This condition, known medically as epiphora, can be both uncomfortable and frustrating. In this comprehensive guide, we’ll explore the causes of watery eyes and discuss available treatments.
Understanding Epiphora: When Tears Overflow
Epiphora is the medical term for excessive tearing that results in tears flowing onto the face. While tears are essential for maintaining eye health, too many tears can be problematic. Let’s delve into why this happens and what it means for your eye health.
The Tear System: A Delicate Balance
To understand epiphora, it’s crucial to know how the tear system works:
- Tear Production: Tears are produced by the lacrimal glands located above each eye.
- Distribution: Tears spread across the eye’s surface with each blink.
- Drainage: Excess tears normally drain through small openings (puncta) in the inner corners of the eyelids.
- Nasolacrimal Duct: Tears then travel through the nasolacrimal duct into the nose.
Epiphora occurs when this system is disrupted, either due to overproduction of tears or inadequate drainage.
Types of Epiphora
It’s important to distinguish between two main types of epiphora:
- Functional Epiphora: Occurs when there’s excessive tearing despite a patent (open) nasolacrimal duct. The tears simply overflow because the drainage system can’t keep up with production.
- Obstructive Epiphora: Caused by a blockage in the nasolacrimal duct, preventing proper tear drainage.
Why Do My Eyes Keep Watering? Common Causes
There are several reasons why you might experience watery eyes. Let’s explore some of the most common causes:
- Blocked Tear Ducts
One of the primary reasons for watery eyes is a blockage in the tear drainage system. This can occur due to:
- Aging
- Injury
- Infection
- Inflammation
When tear ducts are blocked, tears can’t drain properly, leading to overflow onto the cheeks.
- Excessive Tear Production
Sometimes, the issue isn’t with drainage but with overproduction of tears. This can be triggered by:
- Eye Irritation: From allergens, chemicals, or foreign bodies
- Dry Eye Syndrome: Paradoxically, this can cause watery eyes as a reflex
- Infections: Such as conjunctivitis (pink eye)
- Corneal Abrasions: Small scratches on the eye’s surface
- Eyelid Problems
Issues with the eyelids can also lead to watery eyes:
- Ectropion: Outward-turning eyelid
- Entropion: Inward-turning eyelid
- Blepharitis: Inflammation of the eyelids
- Environmental Factors
Sometimes, the environment around us can cause watery eyes:
- Wind
- Dust
- Smoke
- Bright lights
- Allergies
Allergic reactions can cause the eyes to produce excess tears as a protective mechanism.
Why Is Only One Eye Watering?
It’s not uncommon for patients to ask, “Why is only one eye watering?” This can be particularly puzzling and may indicate:
- Unilateral Blockage: A blockage in the tear duct of only one eye
- Localised Irritation: Something irritating one eye but not the other
- Facial Nerve Issues: Problems with the nerves controlling tear production on one side of the face
Diagnosing the Cause of Watery Eyes
At Blue Fin Vision®, our expert ophthalmologists use various methods to diagnose the cause of epiphora:
- Comprehensive Eye Examination: To check overall eye health and identify any obvious issues
- Tear Film Assessment: To evaluate the quality and quantity of tears
- Dye Disappearance Test: To check how quickly tears drain from the eye
- Probing and Irrigation: To check for blockages in the tear drainage system
- Imaging Studies: Such as CT or MRI scans, if structural abnormalities are suspected
Treatment Options for Watery Eyes
The treatment for watery eyes depends on the underlying cause. At our London eye clinic, we offer a range of solutions:
Conservative Treatments
For mild cases or those caused by environmental factors:
- Artificial Tears: To flush out irritants and improve tear quality
- Warm Compresses: To help open blocked glands
- Gentle Eyelid Massage: To promote better tear drainage
- Antihistamine Eye Drops: For allergy-related epiphora
Medical Treatments
For cases caused by infections or inflammation:
- Antibiotic Eye Drops or Ointments: To treat bacterial infections
- Steroid Eye Drops: To reduce inflammation
- Allergy Medications: For chronic allergy-related tearing
Surgical Interventions: Endonasal vs External Dacryocystorhinostomy (DCR)
When it comes to treating nasolacrimal duct obstruction, two main surgical approaches are available: endonasal (endoscopic) DCR and external DCR. Let’s explore these techniques in more detail:
Endonasal DCR
Endonasal DCR is a minimally invasive procedure performed through the nasal cavity using an endoscope.
Key features:
- No external incision, resulting in no visible scarring
- Typically performed under general anaesthesia
- Uses nasal endoscopes and specialised instruments
- Creates a new drainage pathway by removing bone between the lacrimal sac and nasal cavity
- Success rate around 75%
Procedure steps:
- The nasal cavity is prepared and the area near the lacrimal sac is identified.
- A mucosal flap is created, and bone is removed to expose the lacrimal sac.
- The lacrimal sac is opened and connected to the nasal cavity.
- Silicone stents may be placed to maintain the new drainage pathway.
Advantages:
- No external scar
- Faster recovery time
- Can be performed as day surgery
- Preserves the pump mechanism of the orbicularis oculi muscle
Disadvantages:
- Technically more challenging
- May have a slightly lower success rate compared to external DCR
- Limited access in cases of extensive scarring or previous surgery
External DCR
External DCR is the traditional approach and involves creating an incision on the side of the nose.
Key features:
- Small incision (10-12mm) on the side of the nose
- Can be performed under local or general anaesthesia
- Direct visualisation of the lacrimal sac and nasal cavity
- Success rate around 90-95%
Procedure steps:
- An incision is made between the nose and eye.
- The lacrimal sac is exposed, and bone is removed to create an opening to the nasal cavity.
- Flaps are created from the lacrimal sac and nasal mucosa and sutured together.
- Silicone stents may be placed to maintain the new drainage pathway.
Advantages:
- Higher success rate
- Better visualisation of anatomy
- Easier to perform in complex cases
Disadvantages:
- External scar (though usually well-hidden)
- Longer recovery time
- Potential disruption of the medial canthal tendon
Choosing the Right Approach
At Blue Fin Vision®, we carefully evaluate each patient to determine the most appropriate surgical technique. Factors we consider include:
- Patient anatomy and extent of obstruction
- Previous surgeries or trauma
- Patient preferences regarding scarring and recovery time
- Surgeon expertise and experience
While both techniques can be highly effective, the choice between endonasal and external DCR depends on the individual case. It’s important to note that DCR in functional epiphora (where the duct is already open) is less successful, with a success rate of 70-75%. Our experienced surgeons will discuss the pros and cons of each approach with you to ensure you receive the most suitable treatment for your specific condition.
Living with Watery Eyes: Tips and Advice
While seeking professional treatment is crucial, there are steps you can take to manage watery eyes:
- Practice Good Eye Hygiene: Regularly clean your eyelids and lashes
- Protect Your Eyes: Wear sunglasses to shield from wind and debris
- Manage Allergies: If allergies are a trigger, work with your doctor on a management plan
- Stay Hydrated: Proper hydration supports overall eye health
- Avoid Rubbing Your Eyes: This can increase irritation and tearing
When to Seek Professional Help
While occasional watery eyes are normal, you should consult an eye specialist if:
- Tearing persists for more than two weeks
- Tearing affects your vision or daily activities
- You experience pain, redness, or swelling along with tearing
- Only one eye is consistently watering
Why Choose Blue Fin Vision® for Your Eye Care?
At Blue Fin Vision®, our London eye clinic offers:
- Expert Care: Our team of specialist ophthalmologists are leaders in diagnosing and treating epiphora
- Advanced Technology: We use the latest diagnostic and treatment technologies
- Personalised Treatment: Each patient receives a tailored care plan
- Comprehensive Support: From diagnosis through to long-term management
- Convenient Location: Our clinic is easily accessible in central London
Conclusion: Taking Control of Your Eye Health
Watery eyes, while often not serious, can significantly impact your quality of life. At Blue Fin Vision®, we’re committed to providing the highest standard of care for patients with epiphora. Our expert team combines years of experience with cutting-edge technology to offer effective solutions for watery eyes.
Don’t let watery eyes interfere with your daily life. If you’re asking yourself, “Why do my eyes keep watering?” or “Why is only one eye watering?”, we encourage you to book an appointment at our London eye clinic. Remember, early intervention can often lead to simpler, more effective treatments.
Trust the experts at Blue Fin Vision® to provide comprehensive, state-of-the-art care for all your eye health needs, including the management of epiphora. Contact us today to schedule your eye examination and take the first step towards clearer, more comfortable vision.
Your eye health is our priority, and we’re here to help you see clearly and comfortably. Let Blue Fin Vision® be your partner in achieving optimal eye health and saying goodbye to watery eyes.
