Do you feel like you constantly have to dry your eyes? Do excess tears blur your vision or fall down your cheeks on a
daily basis? Too much tear production or poor tear drainage can be more than an inconvenience as overly watery eyes can actually lead to painful irritation and inflammation, as well as potential damage to the eye or eyelids, in extreme cases. Excessive watering can also indicate another problem with the eyes, such as eyelid malposition or dry eye syndrome. Therefore, it is crucial to have your eyes examined by a skilled oculoplastic surgeon to determine what may be causing your excessive tear production and what can be done to correct the problem.
Understanding Tear Production and Drainage
Small glands around the eyes produce tears in order to keep the eyes lubricated and functioning properly. If something irritates the eye, the glands release excess tears to help protect the eye and flush out any debris. The tears then drain away through small drainage ducts that lead to the tear sac at the inner corner of the eyes and then into the nose. If the ducts become blocked or the glands produce too many tears, the excess water will drop out onto the cheeks and face.
Common Causes of Watery Eyes
Excess tear production is typically caused by either poor drainage or overproduction.
Blockage in the tear drainage system
The tear ducts can become blocked by stagnant tears that do not drain out to the nose, often due to inflammation caused by illness or allergies, potentially leading to an infection and further inflammation. With more tear production, the ducts can become even more blocked. Additionally, it is not uncommon for children to be born with narrow drainage channels that may be more easily obstructed.
Weak eyelids that fail to pump tears through the drainage system
Blinking not only helps distributing moisture across the eye, it also activates the drainage system, moving liquid through the ducts and into the sinuses. If the eyelid muscles are weak or an individual does not blink regularly, excess tear production can contribute to blockages as the water becomes stagnant at different points in the ducts.
A wide variety of irritants can trigger the tearing response, such as chemicals, cold wind, conjunctivitis, an injury, or a bit of debris in the eye can lead to excess tear production.
If one or more of the eyelids is turned inward (entropion) or outward (ectropion), the eye can become exposed or irritated, resulting in excess tear production. Entropion can press the eyelashes against the eye, causing irritation, while ectropion pulls the eyelid away from the eye, exposing it to air and debris. These eyelid conditions can often be safely treated with surgery.
Dry eye syndrome
Ironically, watery eyes is one of the main symptoms of dry eye syndrome, a condition in which the tear glands do not produce effective tears that lubricate the eye or the tears evaporate too quickly. The glands respond by overproducing tears to protect the eye from dryness.
Treatments for Abnormal Tear Production
In order to receive effective treatment, it is important to have an accurate diagnosis and a skilled doctor. Depending on the cause of your overly watery eyes, the answer may be as simple as using medicated eye drops, treating the patient’s allergies, or removing an irritant, such as an ingrown eyelash or foreign object. In some cases, the ducts only need to be flushed clean with water by a doctor. However, surgery may be necessary to unblock the tear ducts, widen the openings, or place small tubes to assist with over-production or poor drainage.
A DCR or Dacryocystorhinostomy is an outpatient procedure in which a small piece of bone between the tear sac and the nose is removed, while the lining of the tear sac is surgically attached to the lining of the nose in order to create a clearer and wider drainage duct. The procedure is minimally invasive as it requires only a small incision. Dr. Mehryar (Ray) Taban uses an endoscopic technique in order to prevent any visible scarring and to ensure a faster recovery. The endoscope allows Dr. Taban to make the incision inside the nose where it will not be visible.
Some patients may need to have a small tube placed in the tear sac to prevent scarring and ensure effective drainage. The small tube can be easily removed after two months. The tube may be placed during an endoscopic endonasal DCR procedure.
In the event that the patient’s eyelid is malpositioned, turning inward or outward, correcting the position with a simple reconstructive procedure may be all that is necessary. A skin graft may be used to lift and hold the lid in a comfortable, functional, and aesthetically pleasing position that also eliminates excessive tear production.
Contact the Los Angeles Oculoplastic Surgery Experts
If you are ready to finally treat excessive tearing, inflammation, and infections caused by a blocked or narrow tear ducts, whether with a DCR surgery or a non-invasive treatment, contact Dr. Taban to schedule your initial consultation in our offices in greater Los Angeles area (Beverly Hills or Santa Barbara).
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