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Tearing/The "Watery Eye"
A fairly common ocular complaint is that of a teary or "watery eye". Although rarely associated with any serious eye disease, this condition can sometimes be quite bothersome to the patient. There are many possible causes of excess tearing (epiphora). Interestingly, one of the most common causes is that of dry eye and ocular surface disease which results in a hypersecretion of reflex tears in an attempt to protect the ocular surface (often occurs with prolonged near tasks such as reading and computer use). If dry eye is the cause of tearing, then management will consist of treatment of the dry eye itself including the use of artificial tears. Tearing can present with or without pain. It can be acute or ongoing. And it can vary in frequency occurring very occasionally, intermittently, or constantly.
The causes of tearing can be divided into two main categories:
1. Excess Tear Production/Hypersecretion includes the following causes:
- Irritation of the ocular surface associated with dry eye, environmental conditions, abrasions, foreign bodies, inturned eyelashes, onions, and other causes.
- Blepharitis
- Allergic Conjunctivitis
- Iritis
- Light sensitivity (Photophobia)
- Emotional tearing
- Rarely a lacrimal gland hypersecretion problem
2. Inadequate Tear Drainage includes the following causes:
- Obstruction of the lacrimal drainage system
- Poor function of the drainage system which includes poor eyelid position against the globe of the eye such as associated with ectropion (an out-turned eyelid).
- Congenital nasolacrimal duct obstruction (common in newborn children)
The examination of a teary/"watery eye" should start with a thorough case history. A physical exam of the eye and associated structures should then be conducted. Special test procedures may be required to determine the cause of tearing. Upon the determination of the cause of tearing, the necessary treatment, management, or appropriate referral can then be arranged.
Please select one of the following topics for more information about some of the most common causes of visual impairment or blindness:
Select one of the following topics for more information about other common ocular diseases and conditions:
> Dry Eye and Ocular Surface Disease
