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Epiphora (Watering Eyes): Causes, Symptoms, Diagnosis And Treatment

By Shabana

Our eyes are one of the few organs that have the ability to clean themselves, thanks to the tear ducts and their drainage system. Our tear ducts constantly keep working to keep our eyes moisturised and healthy. The tear ducts located at the corner of our eyes produce tears that help keep our eyes healthy and wash off any foreign objects that enter the eyes. But sometimes there is an obstruction in this system that results in excess production of tears.

Epiphora, commonly referred to as watering eyes, is a condition where tears overflow onto the face instead of draining off into the nasolacrimal system[1] . This may be due to overproduction of tears. Though this condition does not pose a serious threat in terms of health, it may make everyday life a bit more challenging [2] . Excess tears may cloud the eyes and restrict our ability to see. Also, overflowing tears on the face without a reason can be a bit embarrassing at times.

What Is Epiphora

Epiphora can affect people of any age group, though it is common in infants and the elderly. Let us learn more about the seemingly common condition and also learn about some home remedies that help manage the condition effectively.

Causes Of Epiphora

The condition of epiphora can be caused due to two main factors. Overflowing of tears on the face may be because of the overproduction of tears[3] or if the nasolacrimal system isn't functioning properly [4] .

Dysfunctional tear ducts are a common cause of watering eyes. Swollen or narrow tear ducts make it difficult for the tears to drain and hence they end up flowing over the face. The problem is most commonly seen in babies or seniors. Moreover, narrow tear ducts can also be a result of an infection of inflammation. This leads to the build-up of tears in the eyes, which can progress into an infection as well.

Another reason for epiphora is the overproduction of tears. Though most of the time our eyes produce the exact amount of tears required to keep our eyes healthy and functioning, this can sometimes go awry. The eyes end up producing more quantity of tears that can lead to epiphora.

What Is Epiphora

Factors such as foreign objects entering the eyes, infections such as conjunctivitis or chemical fumes can cause the tear ducts to go on an overdrive and produce more tears in order to protect the eyes. Apart from these, there are also certain medical conditions like corneal ulcers, hay fever or dry eyes that result in overproduction of tears.

A proper examination by an ophthalmologist is important to understand the exact cause of epiphora.

Symptoms Of Epiphora

If you are suffering from infrequent bouts of watering eyes, it may not necessarily be epiphora. However, it is important to learn about the other symptoms that will help you distinguish the condition.

People who suffer from epiphora experience one or more of the following symptoms:

• Redness in the eyes that refuse to go away

• Swelling on the eyelids, especially near the tear ducts

• Reduced of clouded vision

• Sharp pain in the eyes.

• Light sensitivity

• Visible blood vessels.

• Heavy eyelids

• Nasolacrimal duct cysts [5]

Suffering from some of these symptoms consistently over a period of time may indicate epiphora.

Diagnosis Of Epiphora

It is quite easy to diagnose the condition. Once you visit a doctor, they will conduct a thorough examination of your lower and upper eyelids in order to determine any swelling or redness. Also, it is important to find out about the exact cause of your condition[6] . If a general physician is unsuccessful in finding out the cause, he or she may refer you to an ophthalmologist.

What Is Epiphora

After examining the eyelids, the doctor may probe the tear ducts to find out if they are blocked. If a blockage is found, a coloured liquid will be introduced into the tear ducts and X-ray will be taken afterwards, to find out the exact location of the blockage.

Your nose passages and sinus cavities can also be examined in order to negate any chances of an infection.

Treatment Of Epiphora

The treatment of the condition largely depends on the exact cause of the eyes watering excessively. Once the cause is determined, it is an easily treatable condition. [7]

• If the watering eyes are caused by a foreign object entering the eyes, a stream of purified water will be introduced into your eyes in order to wash it off.

• Epiphora caused due to eye infections such as conjunctivitis or other bacterial infections are often treated by administering antibacterial medications.

If the doctor notices signs of inflammation or swelling on the eyelids, they may advise you to use a warm compress in order to bring the swelling down.

You can suffer from bouts of epiphora if you are allergic to certain substances such as pollen. Such cases are usually seasonal and blockage of tear ducts usually resolves on their own, without any medications. There are very less cases where the blocked eyelids refuse to clear up. In such cases, a small corrective surgery may be required to open them up. [8]

What Is Epiphora

Watering eyes in newborns usually do not require any medication as the conditions settles down once their tear ducts open up and their drainage system starts functioning normally [9] .

Most of the cases of epiphora do not usually require medical intervention. There are a lot of home remedies as well that will help you manage the condition.

Here are a few home remedies that will help you manage excessive watering eyes:

1. Salt water

Warm salt water is said to be the best home remedy to treat watering eyes [10] . It not only disinfects the eyes but also helps you get rid of any dryness that can cause your eyes to produce excess tears.

Just heat up a cup of water and add a teaspoon of salt. After the salt dissolves, you can dip two cotton pads in the solution and place it over your eyes for 5 minutes. Repeat this daily until the symptoms subside.

2. Rose water and Honey

Rose water is known to be an excellent remedy for watering eyes. To make this more effective, you can add a few drops of honey. Both the natural ingredients will help reduce any inflammation in the eyes and clear the obstruction in the tear ducts. This pack will also give you a soothing relief from the pain associated with epiphora.

3 large tablespoons of rose water can be mixed with half a teaspoon of honey. Dip cotton pads in the mixture and place it over your eyes. You can even administer the mixture into your eyes through droppers. Regular usage of this remedy will help resolve epiphora.

3. A warm compress

This is known to be a very effective remedy in treating as well as managing epiphora. A warm compress, along with a gentle massage, will help you remove any oil and debris from the eyes[11] .

Apply a warm compress over your eyes for 10 minutes. After this, you can use your ring fingers to give a gentle massage over the eyelids. Using a cotton swab, you can further clean your tear line to remove any dirt or obstructions on the tear ducts. This is a rather simple process but will certainly go a long way in helping you maintain healthy eyes.

What Is Epiphora

4. Cucumber

The soothing sensation that cucumbers provide when placed over the eyes serves a medical purpose as well. If you are suffering from inflammation of the tear ducts, this remedy may just be right for you. Cucumbers will help calm down the irritation in your eyes and also control excessive watering.

Cut two slices of cucumber which is taken straight out of a refrigerator and place them on your eyelids. You will feel instant cooling sensation and will notice a reduction in tears over time.

5) Warm tea bags

Tea bags work similar to the warm compress in treating watering eyes. In fact, teas such as chamomile, spearmint and peppermint are great and have been used since ages to treat the condition.

Warm tea bags discarded after preparing the tea can be placed over the eyes for 5 minutes. They not only condition the eyes but also help moisturise the eyes and reduce inflammation.

Conclusion

The above home remedies will certainly help you manage the condition effectively. However, it is important to consult your doctor for longer lasting treatments if you suffer from epiphora quite frequently.

Also, if you are a contact lens wearer, you have higher chances of suffering from epiphora. Make sure to follow all the guidelines that come with handling contact lens every day. General health rules advice you to visit your ophthalmologist regularly to keep your eyes healthy and problem free.

View Article References
  1. [1] Shen, G. L., Ng, J. D., & Ma, X. P. (2016). Etiology, diagnosis, management and outcomes of epiphora referrals to an oculoplastic practice.International journal of ophthalmology,9(12), 1751–1755.
  2. [2] Shin, J. H., Kim, Y. D., Woo, K. I., & Korean Society of Ophthalmic Plastic and Reconstructive Surgery (KSOPRS) (2015). Impact of epiphora on vision-related quality of life.BMC ophthalmology,15, 6.
  3. [3] Williams, B., Johnson, D., Hurst, J., & Kratky, V. (2014). Patterns and causes of epiphora referrals to a tertiary oculoplastic practice.Canadian Journal of Ophthalmology/Journal Canadien d'Ophtalmologie,49(2), 180-182.
  4. [4] Nemet, A. Y. (2016, May). The etiology of epiphora: a multifactorial issue. InSeminars in ophthalmology(Vol. 31, No. 3, pp. 275-279). Informa Healthcare.
  5. [5] DelGaudio, J. M., & Wojno, T. (2007). Nasolacrimal duct orifice cysts in adults: a previously unrecognized, easily treatable cause of epiphora.The Laryngoscope,117(10), 1830-1833.
  6. [6] Schargus, M., & Geerling, G. (2017). Diagnosis and treatment of the watering eye.HNO,65(1), 69-84.
  7. [7] Wong, P. Y., Charn, T. C., Ismail, A., & Tatla, T. (2015). Teary eyes due to 21 pence?.BMJ case reports,2015, bcr2014206947.
  8. [8] Blackmore, K. J., Ainsworth, G., & Robson, A. K. (2010). Epiphora: an evidence based approach to the 12 minute consultation.Clinical Otolaryngology,35(3), 210-214.
  9. [9] Clarke, W. N. (1999). The child with epiphora.Paediatrics & child health,4(5), 325-326.
  10. [10] Avram, E. (2017). Insights in the treatment of congenital nasolacrimal duct obstruction.Romanian journal of ophthalmology,61(2), 101.
  11. [11] Matsumoto, Y., Dogru, M., Goto, E., Ishida, R., Kojima, T., Onguchi, T., ... & Tsubota, K. (2006). Efficacy of a new warm moist air device on tear functions of patients with simple meibomian gland dysfunction.Cornea,25(6), 644-650.

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