Watery Eyes are a consequence of either excess production of tears or inadequate drainage of tears.The eyes have a self-cleaning and lubricating mechanism in the form of tears. They are are produced from the lacrimal glands which are situated on the upper-outer aspect of the eyeball and drained via the lacrimal sac and nasolacrimal duct into the nose.

Causes

Watery eyes are a consequence of either excess production of tears or inadequate drainage of tears

A) Common conditions causing excess production of tears :

1)  Emotional states , Laughing , yawning , Coughing .

2)  Excessive eye strain

3)  Weather conditions such as extreme wind , cold , strong sunlight

4)  Common cold , sinus problems

5)  Exposure to chemical fumes , even onions

6)  Foreign body in the eye

7)  Eye infections

8)  Eye allergy

9)  Dry eyes

10)   Eyelid malposition – inward or outward turning of the eyelid

B) Condition causing inadequate drainage of tears : Blocked tear duct also known as  nasolacrimal duct obstruction. This can occur commonly in infants (congenital nasolacrimal duct obstruction) as well as in adults

Congenital nasolacrimal duct obstruction :

Over 5 % of infants have clinical symptoms of nasolacrimal duct obstruction (i.e watering and discharge from one or both eyes). It occurs due to a membrane at the lower end of the tear duct. 90% of cases resolve spontaneously within the first year of life. It is important that the eyes be examined for uncommon but important other causes of tearing in infants including childhood glaucoma.   

Adult nasolacrimal duct obstruction :

Usually occurs due to idiopathic or inflammation related narrowing of the tear duct, but in rare cases can be secondary to trauma / benign or cancerous intranasal pathologies.  This is twice more common in females as compared to males possibly due to their tear ducts being narrower. Symptoms include persistent watering of eyes commonly associated with discharge . Stagnation of tear secretions within the tear sac can cause secondary infection and swelling of the tear sac – a painful condition known as acute dacryocystitis , which would require immediate treatment with oral antibiotics. Chronic inflammation of the tear sac presents with less inflammatory signs and requires surgical treatment.

Management

This depends on the cause and severity .  An eye doctor will help ascertain the cause and guide towards appropriate management.

1)  Eye infections – use of antibiotic eyedrops

2)  Eye allergies – use of antiallergy eyedrops

3)  Foreign body in the eye – requires removal

4)  Exposure to chemicals – requires a thorough eye wash

5)  Dry eyes – use of appropriate lubricant eyedrops and eye care regime

6)  Eyelid malpositions – usually require surgical intervention

      7)     Congenital nasolacrimal duct obstruction :

If the child age is less than 12 months : Chances of spontaneous resolution are high . Supplementary measures include : Tear duct massage , antibiotic eye drops

If the age is more than 12 months : Chances of spontaneous resolution are low. Tear duct probing is a procedure where an attempt is made to open the membranous blockage of the tear duct , performed under general anaesthesia

8)      Adult nasolacrimal duct obstruction :

Requires surgical intervention to create  a  new drainage pathway into the nose – the procedure is known as dacryocystorhinostomy (DCR)

Home remedies for watery eyes  : Many cases of watery eyes may resolve without any treatment or with simple remedies

1)  Taking a break from reading , watching TV or using the computer

2)  Holding a clean , warm damp cloth and massaging the eyelids

3)  Lubricating the eyes with over the counter lubricant eyedrops

When to contact the eye doctor                 

1)  Associated visual disturbances

2)  Associated pain / redness / swelling

3)  Discharge from the eye

4)  Injury to the eye / fall of chemical in the eye

5)  Foreign body sensation in the eye