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.

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

Blepharospasm (Eye Twitching)

Almost everyone at some time in his or her life has experienced a frequent and annoying muscle twitch of the eyelid. It may have followed a late night of studying or hours of driving, stress or drinking caffeinated beverages. Usually, this annoyance disappears after a period of rest and relaxation. Occasionally, the spasms are caused by an actual change in the eye’s physical makeup and the spasms do not go away, but rather become a constant annoyance.


Due to a nervous system disorder, such as Tourette’s syndrome, or an irritation on the surface of the cornea or the conjunctiva (the outermost lining of the eye under the eyelid), the eye will frequently or continuously twitch (spasm). Vision is generally not affected except in the most severe cases where the eyelid(s) remain shut. Frequently, dry-eye syndrome is experienced along with blepharospasm. Occasionally, blepharospasm is drug-induced and will be resolved when the dosage is reduced.


Blepharoplasty is a surgical procedure to repair excessive skin and “swelling” eyelids. It is becoming one of the most common elective surgeries performed. The apparent swelling is usually a natural result of the aging process or, less frequently, a result of a disease state that causes the muscles around the eyes to degenerate. Regardless of the cause, the face and especially the eyes are considered key to a person’s appearance. The desire to correct the cosmetically bothersome condition is very common.

Pre-Surgery Evaluation

The surgeon will first take pictures of your eyes, and will probably ask for pictures of you taken before the condition was present. A thorough history and physical exam to determine health status before the surgery will be taken. Sometimes only the skin is removed; at other times fat tissue is removed as well.

Certain conditions can make the procedure more risky, such as thyroid disease, dry eye syndrome, diabetes, heart disease including high blood pressure and certainly any eye disorders (cataracts, glaucoma). An ophthalmic exam will also be necessary to detect any eye disorders, and to measure vision and eye movement before the surgery.


Sagging or drooping of the upper eyelids is called Ptosis (toe sis). The sags and droops are usually a natural result of the aging process. However, certain disease states such as diabetes and high blood pressure can affect the blood or nerve supply to the eye muscles and cause the nerves around the eyes to degenerate. Another less-common cause is nerve damage following eye surgery. Congenital ptosis is an eyelid problem present at birth. Regardless of the cause, the face, and especially the eyes, are considered key to a person’s appearance. The desire to correct the lack of muscle tone around the eyes is very common.


Ptosis can affect vision regardless of age or cause of the condition. The drooping eyelid may partially or completely cover the pupil resulting in blurry or double vision. In worst cases, it can totally restrict vision.