Excessive Tearing (Epiphora)

A healthy eye is a wet eye, thanks to the workings of the lacrimal (tear duct) system around the eyes. The lacrimal gland is found above the outer edge of the eye under the eye brow. The lacrimal duct,which forms tears, is found on the inside corner of your eye and down the side of the nose. For various reasons, this system can malfunction and cause the eye(s) to be continuously wet.

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Symptoms and Causes of Epiphora

The tear duct is the passage through which the tears drain off the eye. When it becomes blocked or plugged, it may lead to:

  • constant tearing
  • redness and swelling in and around the eyes
  • infection
  • pain

The blockage may be due to:

  • mucous buildup in the lacrimal duct at birth and in infancy
  • ingrown eyelashes
  • thick or hardened discharge from an eye infection such as conjunctivitis (pink eye)
  • continued exposure to allergens that irritate the eyes
  • obstruction due to airborne irritants especially in the work environment (i.e. dust, chemicals, smoke or pollution)
  • other eye conditions, such as a stye, that cause the eye to have an unusual discharge that can harden and plug the lacrimal duct.

Treatment

The ophthalmologist will examine the eye and may probe the tear duct to determine if a blockage exists. Initially, antibiotic drops will be prescribed to treat the infection, and possibly corticosteroid drops to treat any swelling. The blockage can often be worked loose by massaging the tear duct along the side of the eye and down the nose.

If the blockage persists, the ophthalmologist may choose to probe the duct with a small metal wire that can force the blockage loose, and the duct can be thoroughly washed out. This is usually a painless procedure and can be performed in the doctor’s office.

If the blockage continues to return over and over again, the ophthalmologist may suggest surgery to implant an artificial tear duct called a “Jones tube” to permanently open the lacrimal duct. A surgeon who specializes in ophthalmic reconstruction and plastic surgery usually performs this surgery.

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