Posted by: Heaton Eye Associates in Dry Eye

Watery eyes seem like a minor symptom until you’re dabbing your cheeks mid-conversation and carrying tissues everywhere. Persistent tearing almost always comes down to one of two problems: your eyes are making more tears than usual, or the tears they make have nowhere to go.

The most common cause surprises many people, because it is named for the opposite symptom. Keep reading to find out what makes eyes water, how tears normally drain, and which symptoms mean it’s time to see an eye doctor.

What Causes Eyes to Water?

Your eyes produce a small, steady supply of tears all day to keep the surface smooth and clear. When something irritates the eye, a second system kicks in and floods it with reflex tears. Most cases of overproduction fall into one of the categories below.

Dry Eye

It sounds backward, but dry eye is one of the most common reasons eyes water constantly.

When the surface of the eye dries out, nerves in the cornea send a distress signal, and the eye responds with a rush of watery reflex tears. Those tears lack the right balance of oil, water, and mucus, so they spill over or evaporate quickly instead of coating the eye. The surface dries out again, and the cycle repeats.

A common culprit is meibomian gland dysfunction, also called MGD, which happens when the tiny oil glands along the eyelid margins become clogged. Without enough oil, the tear film evaporates too fast.

Dry eye symptoms often include tearing along with grittiness, burning, redness, and blurred vision, which is why many patients who come in for watery eyes leave with a dry eye diagnosis.

Artificial tears help some people, but they do not unclog the glands. Heaton Eye Associates offers the iLUX MGD Treatment System, an in-office procedure that uses light-based heat and gentle compression to clear blocked glands so the eye can hold onto its natural tear film.

Allergies

Allergies trigger the release of histamine in the tissues around the eye, which leads to itching, redness, puffy lids, and watery eyes. Allergy-related tearing usually affects both eyes at once and tends to flare when pollen counts climb. Allergy eye drops recommended by an eye doctor can calm the reaction at its source.

Wind, Smoke, and Screens

Wind, cigarette smoke, dust, and dry indoor air from heating and air conditioning can all prompt reflex tearing. Screens contribute in a less obvious way. People blink far less often while staring at a phone or computer, so the eye surface dries out and the eye compensates with watery tears.

Infections and Misdirected Lashes

Conjunctivitis, or pink eye, often causes tearing along with redness and discharge. Tearing can also come from a single eyelash growing in the wrong direction and brushing the eye with every blink, a condition called trichiasis. The eye treats the lash as a foreign object and tries to wash it away.

Tears That Can’t Drain

Sometimes your eyes make a normal amount of tears, but the tears have no way out. A lower eyelid that sags away from the eye, an eyelid that rolls inward, or a narrowed or blocked tear duct can all cause tears to pool and spill over.

Where Do Your Tears Go In Your Eyes?

Each time you blink, your eyelids sweep tears across the eye toward the inner corner. Two tiny openings there, one on the upper lid and one on the lower, collect the tears and channel them through small canals into a sac beside the nose. From there, tears drain down the nasolacrimal duct into the nasal cavity.

If any part of that path is blocked or out of position, tears back up and spill onto your cheek even when production is perfectly normal.

When Tears Can’t Drain Properly

Drainage problems often develop gradually, and they become more common with age as the tissues around the eye lose firmness.

Eyelids That Turn In or Out

The lower eyelid needs to rest snugly against the eye for the drainage opening to collect tears. With ectropion, the lower lid sags or turns outward, pulling that opening away from the tear film. Tears pool and run down the face, and the exposed surface dries out, triggering even more tearing. Entropion is the reverse. The lid folds inward, and the lashes rub against the eye, causing redness, a constant feeling that something is in the eye, and watery eyes.

Artificial tears and ointments can ease symptoms of both conditions for a while. Because an eyelid that turns in or out leaves the cornea vulnerable to abrasions and ulcers, surgery to reposition and tighten the lid is usually needed for full correction.

Blocked Tear Ducts in Adults

In adults, the nasolacrimal duct can narrow over time or become blocked after an infection, a facial injury, or chronic sinus inflammation. When the tear drainage pathway is blocked, tears have no natural way to leave the eye. Many people notice tearing in just one eye, sometimes with crusting, recurring infections, or a tender bump near the inner corner.

Treatment depends on where the blockage sits and how complete it is. Partial blockages may respond to probing or dilation of the duct. A complete blockage often requires a procedure called dacryocystorhinostomy, which creates a new drainage path from the tear sac into the nose. This is delicate work performed by an oculoplastic surgeon.

Signs Your Watery Eyes Need an Exam

Many people put off an eye appointment because they can still see well enough to drive, read, and work. Clear vision does not mean the eye is healthy, though, and chronic tearing can signal dry eye disease, eyelid malposition, or a blocked duct that worsens without treatment. Excess tearing is one of the signs that an adult should schedule a comprehensive eye exam, even when no other symptoms are present.

Some symptoms call for a prompt visit rather than a routine appointment:

  • Eye pain or a feeling of something stuck in the eye that does not go away
  • Blurred vision or other changes in how you see
  • Thick, colored discharge or crusting along the lashes
  • Constant tearing in only one eye
  • Swelling, redness, or tenderness at the inner corner near the nose

Heaton Eye Associates brings optometrists, cornea specialists, pediatric specialists, and an oculoplastic surgeon together in one multi-specialty group, so most patients can have the cause of their tearing diagnosed and treated without leaving East Texas.

Tired of wiping away tears that never seem to stop? Schedule an appointment at Heaton Eye Associates in Tyler, Longview, or Athens, TX.