The Causes Of A Watery Eye And The Available Remedies A watery eye can be due to many causes. It is essentially an imbalance between the volume of tears being produced by the tear gland and the amount that can be removed by evaporation and the tear drainage system. Problems with the eyelids or narrowing of the drainage canals can prevent tears from being drained away efficiently into the nose and throat. Some people have more than one factor causing their watering. Even some people with dry eyes may also experience watering due to reflex tearing as the eye attempts to keep itself moist.
Tears are produced continuously and are drawn into a small hole in the inner corner of your eyelid known as a punctum. There is one in the upper and lower eyelid. The punctae lead into small tubes known as the canaliculi, which in turn drain into the lacrimal or tear sac. This lies between the corner of your eye and your nose and has a duct at the bottom, which drains into your nose, the nasolacrimal duct. If the nasolacrimal duct becomes blocked, the eye becomes watery and sometimes sticky. Some people develop a painless swelling of the tear sac at the inner corner of the eye and a few get repeated painful infections, like a boil or abscess. A blocked tear duct occurs because the normal tear drainage system does not have much spare capacity, which is why the tears spill onto the face when you produce excessive tears such as when you cry or when you laugh until tears pour down your cheeks. The narrow drainage channel becomes even narrower with age, especially if there has been facial trauma or sinus disease. Although most watery eye problems won’t require surgery, surgery may be necessary in some cases. If you suspect that your problem is a little more serious, it is best to go see your doctor. Your doctor will examine you to see if your watering is due to a problem in the tear drainage system. This will include syringing water through the tear ducts to see whether there is a blockage. An endoscope/telescopic is used to examine the inside of your nose. Sometimes an x-ray examination of the tear drainage pathway (a dacryocystogram or dacryoscintillogram) is needed to help determine the cause of your watery eye or the site of obstruction to tear flow. Unblocking the tear duct involves a surgical procedure that creates a new pathway between the tear sac and the inside of the nose by removing a small piece of bone between them and bypassing the blocked nasolacrimal duct. This operation is called a dacryocystorhinostomy or DCR for short. In a few patients, a small soft silicone tube or stent is placed in the tear duct/canals to keep the passages open while healing takes place. This is removed 6 weeks after the surgery in the outpatient clinic. In most cases where the obstruction of the tear duct is in the nose, there is a 90-95% success rate. This means that an overwhelming majority of people that undergo the surgery will have an improved quality of life afterward. The operation takes about an hour and is usually performed under a general anesthetic where you are asleep, or under a local anesthetic with intravenous sedation to make you sleepy so you do not feel any discomfort. You may be able to have the surgery as a day patient and go home the same day or you may be admitted overnight. Your doctor will discuss which will suit you best at your consultation. However, what is important to note is that it has a very high chance of an improved condition afterward.
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