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Why have I got Watery Eyes?

Funnily enough, watering eyes can be a symptom of what is seemingly the exact opposite condition – dry eyes!

If you’ve ever been in a plane with its air conditioning system pushing out very cold and very dry air, especially over a long haul flight, the normal moisture on the surface of the eyes evaporates. The eyes can sometimes blink more than usual to produce tears to overcome the unnaturally dry eyes, so much so that the eyes temporarily water excessively.

Once the flight is over of course the eyes return to normal and all is forgotten. However if watery eyes persist, it could mean something could be wrong, but in most cases readily treated.

Other non-disease causes of watery eyes are dust and grit in the eyes, heavy traffic pollution, an allergy of some kind, reactions to chemicals and chopping up onions – the list goes on and on!

On the subject of allergies, whilst they may not be diseases exactly, they are symptomatic of environments which can be examined and managed. The simple act of changing pillows, where you spend up to a third of every day, can provide a simple solution. A damp home, especially in winter is another source of managed allergies.

If a pharmacy over the counter (OTC) medication doesn’t alleviate the problem of watery eyes, then obviously it’s time for a visit to your certified therapeutic optometrist.  Occasionally surgical intervention might be required.

More sinister causes of watery eyes

Watery eyes can occur at any time, but babies up to 12 months old and people over 60 seem to be more prone.

Watery eyes, sometimes referred to by the medical name of “epiphora” either from the Latin word meaning repetition, or maybe the Greek word meaning bringing upon, can be caused by a few things that are a bit more sinister:

•    Conjunctivitis, of which there are several types ranging from mild to severe, produce red eyes almost always watery eyes.

•    Blepharitis – this is the medical term used for inflamed eyelids with scaly surfaces, a bit like eczema, with smoke and sunlight especially make the eyes water

•    Eyelashes growing inward, so as to contact the eye – there are two ways this can happen. The term “entropion” is used to describe what happens when the lower lid turns inwards (and the eyelash with it), whilst “trichiasis” causes a similar effect, but happens due to the eyelashes themselves growing inwards (curving the wrong way). Whatever way it happens of course, it will be quite uncomfortable.

•    Lower eyelid turning down –called “ectropion”. In this condition, the eyelid turns down and sags outwards, preventing them from effectively draining the tears away.

•    Blocked tear ducts – tears lead outwards to the nose through what’s appropriately called the nasolacrimal duct.  If this is blocked in any way then watery eyes are a consequence.  This can sometimes be just flushed with a syringe and sterile saline or require reconstructive surgery.

Treating Watery Eyes

Mild cases of watery eyes can often be “cured” by waiting and watching – why introduce treatments when nature can and probably will take its course? The various underlying causes of watery eyes need active management:

•    Dry eyes can be treated by a programme of eye drops developed “under the watchful eye” of an Optometrist, taking care not to use drops more than four times a day unless they are in ampules and non-preserved.

•    Infections such as a mild conjunctivitis can be remedied using antibiotics or anti-inflammatories.

•    Allergies are mostly cleared up by use of an antihistamine / mast cell stabilisers – but the best approach is to try and identify the cause of the allergy and remove it if possible.

•    Blepharitis is not always serious and you may not even know you have it; it will of course be spotted by your optometrist if he or she is on the ball. Preservative-free artificial tears can be used as eye drops for treatment of minor cases, antibiotics in more severe cases and steroid creams only in the worst of cases, but then ideally only in the short term.

•    In the cases of the eyelash entropion and ectropion surgical reconstruction is likely to be the best option.

•    Blocked tear ducts – if the watery eye symptoms occur more than ten times a day then surgery to introduce a channel from the eye to the nose may be needed, usually after first injecting a dye into the tear duct to see if and where it comes out.

Bottom line see your therapeutic optometrist once again; they will either treat it or refer you to a surgeon that is best trained to help you.

About the Author

Dr Jim Kokkinakis (Optometrist) graduated in 1983 from the Optometry School University of NSW. He is currently a Senior Lecturer there and regular speaker to both Optometrists and Ophthalmologists in Australia and Internationally. He has a specialist clinical practice in the Sydney CBD with interests in Eye Strain, Computer Vision problems, Treatment of Eye Diseases and complex Contact lens Fittings.

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