Have you ever wondered why your eyes water constantly, even when you aren’t crying?
Excessive tearing, medically known as epiphora, is a common condition that can significantly impact your daily life, making reading, driving, or working on a screen uncomfortable. The tear film is essential for lubricating, nourishing, and protecting the surface of your eye. However, when the system becomes unbalanced, tears accumulate and overflow.
Understanding the root cause of watery eyes comes down to two main mechanisms: overproduction or underdrainage.
1. Overproduction: Your eyes are making too many tearss
When the delicate surface of the eye becomes irritated or inflamed, it triggers “reflex tearing.” Your eye responds by producing an excessive influx of tears to protect itself. They may not be the right concentration of nutrients in your tears so may not help the root cause and is meant to be a temporary fix from your body.
Common Causes of Overproduction:
- Irritation: Foreign bodies, wind, or smoke irritating the ocular surface.
- Dry spots on the cornea: Having chronic dry eyes is one of the most frequent causes of watery eyes. Over time, unmanaged dry spots on the cornea can lead to scarring and cloudiness, potentially affecting your vision.
- Conjunctivalchalasis: Loose or excess folds of the conjunctiva (the clear membrane over the eye) interfering with normal tear distribution on the ocular surface.
- Allergies & infections: Ocular allergies or viral infections causing surface inflammation. (Read our prior blog on eye allergies)
Treat the underlying cause of irritation to restore balance to your ocular surface.
2. Underdrainage: Tears Are Not Draining Properly
Normally, every time you blink, your tears drain through tiny openings in the corners of your eyelids called the puncta, travel through small channels (canaliculus and nasal lacrimal duct), and empty into your nose. If there is a disruption anywhere along this pathway, tears overflow.
Common Causes of Underdrainage:
- Eyelid position & laxity: As we age, skin and eyelid tissues can sag away from the eyeball. Loose lids prevent tears from properly reaching the puncta. While your lacrimal gland (the small, tear-shaped gland above your eye) is doing its job making the watery layer of your tear film to protect your eye surface, loose eyelids keep those tears from spreading evenly or draining away as they should.
- Blocked tear duct: A blockage can occur anywhere along the tear drainage system, from the puncta to the nose. When tears cannot drain properly, they overflow onto the cheeks, causing persistent watery eyes and increasing the risk of eye irritation and infections. Causes may include sinus disease, tear duct infections, tear duct stones, trauma, or tear duct stenosis (narrowing). Sometimes we purposely block the tear duct to help dry eyes with punctal plugs by keeping more tears on the ocular surface.
How We Diagnose and Treat Watery Eyes
Because epiphora can stem from a combination of surface irritation, eyelid positioning, or structural blockages, a comprehensive clinical evaluation is essential.
- In-office tear duct flushing: A diagnostic procedure performed right in our office to check for any blockages in your tear drainage system. If a complete tear duct obstruction is found, Dr. Pradhan can refer you to an Oculoplastics surgeon for specialized surgical care. Sometimes, flushing the tear ducts is enough to open them up along with using saline nose spray for a week to keep it open.
- Treatments for loose eyelids & conjunctivalchalasis: If loose lids or eyelid malposition are causing your tearing:
- Stop rubbing your eyes: Eye rubbing stretches delicate tissues and worsens lid laxity.
- Consider OptiLift: An innovative option that tightens loose lids, improves your blink efficiency, and helps reduce both dry eye symptoms and watery eyes. OptiLift is not covered by insurance.
- Plasma Pen & cosmetic options: Can assist in tightening the skin around the eyes as well as loose conjunctiva (conjunctivalchalasis), helping to improve tear movement. The treatment on the conjunctiva is covered by insurance but the treatment on the outside eyelid skin is not covered by insurance.
You don’t have to live with the daily discomfort and blurred vision caused by watery eyes. Treating the root cause allows you to live comfortably and see the world around you with clear vision.
Call our office today at (804) 270-3333 to schedule a thorough consultation with Dr. Pradhan and find the right solution for your eyes!
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Dr. Shilpi Pradhan is a board-certified ophthalmologist, cornea specialist, and founder of Eye Doctor MD PC. Beyond providing advanced clinical treatments for dry eye disease, she guides patients in adopting targeted lifestyle changes to improve both their eye health and overall whole-body wellness. As one of the first Virginia ophthalmologists board-certified in Lifestyle Medicine (2020) and a member of the American College of Lifestyle Medicine (ACLM), Dr. Pradhan combines modern ocular care with evidence-based nutrition and habit changes to support long-term Vision Healthspan.