ADULT OPTHALMOLOGY: WATERY EYE

Everybody experiences watery eyes from time to time and it’s usually nothing to worry about. Producing tears is vital for keeping the eyes healthy and protected – and this can become more noticeable if something irritates the eye, such as a gush of wind or a small piece of debris, causing the eye to start streaming. For some people though, constant watery eyes can become problematic and may be a sign that something is wrong.

Eyes constantly watering can be caused by a number of things, so it’s important to have the problem checked by a specialist and appropriately treated and managed. Sometimes, watering or streaming might be the only issue or there might also be other symptoms too, such as itchy watering eyes, inflammation, blurred vision or dryness, and one or both eyes may be affected.

The causes of watery eyes include:

Watery eyes can occur alongside a range of conditions affecting the eyes. For example, some people may experience watery eyes after cataract surgery, and having very droopy eyelids or eyelids that turn inwards can sometimes be a factor in eye watering. It’s important to have the problem assessed by a specialist as soon as possible, in case further investigation and treatment is required.

Most often however, when we talk about watery eyes, these are the three main causes: 

  • Blocked tear duct. Known medically as the nasolacrimal duct, tear ducts enable tears to drain away from the eye into the nose and throat. If these ducts become blocked, eyes can become very watery and there’s often blurring and redness too. People with blocked tear ducts can be at risk of recurrent eye infections and inflammation and sometimes the eyes can produce pus and crusting too, which can be very uncomfortable. In adults, a number of things can cause tear ducts to become blocked, including age-related changes in the eye, chronic infections or injury to the area. Certain medications may cause blockages to develop, and in very rare cases there may be a tumour in the eye. People who’ve had previous eye surgery can be more at risk of blocked tear ducts too.
  • Dry eye syndrome. Despite being called ‘dry’ eye syndrome, excessively watery eyes is a key symptom of this common condition. Eyes may also feel gritty and irritated and more sensitive to bright light and vision might be blurry. Dry eye syndrome is most common in over-50s, people who wear contact lenses, or spend a lot of time looking at computer screens. Other conditions – including Sjögren’s syndrome, lupus and blepharitis – and certain medications can sometimes be linked with dry eye syndrome too.
  • Allergies. Watering eyes can be a common symptom of allergic reactions, and many people with allergies will be familiar with hay fever watery eyes. There will usually be other symptoms too, such as itching, redness and irritation of the eye (you can find more information about this on our Allergic Conjunctivitis page), along with sneezing and nasal congestion/runny nose. Allergies can affect men and women of all ages and vary in severity. 

Treatment of watery eyes:

How to reduce watery eyes depends on the severity of the problem and the underlying cause. 

For children diagnosed with a watering eyes due to a blocked tear duct, a small surgical procedure to correct the blockage may be required. The procedure is carried out under general anaesthetic, although you’ll usually be able to go home the same day. It involves gently passing a very fine metal probe through the tear duct, then flushing the blockage away with water. Success rates for the procedure are very high (90-95%) although some people may require the surgery to be repeated in the future if a blockage returns.

For adults, syringing can be carried out under local anaesthetic in clinic. If this is insufficient to resolve the block, a dacryocystorhinostomy (DCR) procedure may be required. In some cases lid surgery might be enough to restore the normal tear drainage pathway

Dry eye syndrome can be managed with eye drops to help reduce dryness and soothe irritation. Lifestyle measures, such as ensuring you get plenty of screen breaks if you work at a computer, avoiding harsh air conditioning and wearing sunglasses outside, can also help. For watering eyes linked with an allergy or hay fever, managing the allergy is a crucial first step, while treatments including eye drops can help manage allergic conjunctivitis symptoms.

Out of hours aftercare:

Mr. Jain is always happy to receive calls if a patient is having difficulties after surgery. Call his secretary or the hospital at which the surgery was carried out and they will give him your contact details. If you have any further questions, please feel free to send us an email.

Mr Saurabh Jain

Saurabh Jain Is a Consultant Ophthalmic Surgeon and Clinical Director of services at the Royal Free London NHS Foundation Trust.