Constant or excessive tearing can be a sign of underlying eye or tear drainage problems requiring assessment.
Introduction and Overview
Epiphora is the medical term for excessive tearing or watery eyes. Tears normally lubricate and protect the ocular surface, but when tear production is excessive or drainage is impaired, tears can overflow onto the face. This may be temporary (for example due to irritation) or persistent and related to underlying conditions affecting the tear film or tear drainage system.
Epiphora can occur in one eye (unilateral) or both eyes (bilateral) and affects people of all ages. Chronic symptoms are more common in adults over 50 and in infants.
- It can occur when tear production is increased or when normal tear drainage is impaired.
- Epiphora may affect one or both eyes and can be intermittent or persistent.
- Causes range from surface eye irritation and dry eye to obstruction of the tear drainage system.
- In many cases, epiphora is treatable once the underlying cause is identified.
- Persistent watery eyes should be assessed to exclude tear duct obstruction or eyelid abnormalities.
Symptoms and Diagnostics
Common Symptoms
People with epiphora may notice:
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Tearing that runs down the cheek or pools in the eye
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Continuous or frequent watery eyes
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Blurred vision or glare due to tear overflow
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Eye irritation or redness
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Symptoms that do not improve with blinking alone
Common Causes / Contributing Factors
The cause of epiphora can vary and may include:
- Excess tear production due to surface irritation, dry eye reflex, allergies or infection
- Obstruction or narrowing of the tear drainage system (e.g. blocked tear ducts)
- Eyelid malposition or eyelash abnormalities affecting tear flow
- Inflammation of the ocular surface or eyelids
How Epiphora May Affect the Eyes
Excessive tearing is the most noticeable effect of epiphora. When it affects one eye, it is often described as unilateral epiphora, while involvement of both eyes is referred to as bilateral epiphora.
Depending on the underlying cause, epiphora may also be associated with:
- Eye discomfort or pain
- Itchiness or irritation around the eyes
- Redness of the eye or eyelids
- Cloudy or fluctuating vision due to tear overflow
- Pressure or discomfort around the nose or sinuses
Epiphora Treatment and Management
Surgical assessment and management of epiphora is provided by our ophthalmic surgeons where appropriate. Depending on the underlying cause, this may include procedures to address eyelid laxity or surgery to bypass obstruction of the lacrimal drainage system, such as dacryocystorhinostomy (DCR).
Medicine
Epiphora related to ocular surface irritation, inflammation, allergy or infection may be managed with medication. Treatment is directed at addressing the underlying cause of excessive tearing and may include:
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Lubricating eye drops for tear film instability or reflex tearing
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Prescription eye drops for inflammatory or infectious conditions
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Management of allergic eye disease where relevant
Medical treatment is often sufficient when epiphora is secondary to reversible surface or inflammatory causes.
Removal of Surface Irritation or Foreign Bodies
If tearing is caused by a foreign body or surface injury to the eye, this will be identified and managed during examination. In cases of more significant injury, further treatment may be required to address any underlying damage.
Blocked Tear Ducts
When epiphora is caused by obstruction of the tear drainage system, treatment may involve irrigation of the tear ducts or gentle probing to restore drainage. If the blockage is persistent or structural, surgical options may be considered.
Eyelid or Eyelash-Related Causes
Abnormal eyelid position or eyelid laxity can interfere with normal tear drainage. Where appropriate, surgical correction of the eyelids may be performed to improve tear outflow and reduce watering.
More information can be found below:
Clinical Disclaimer
The information provided on this page is for general educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Every individual’s condition is unique, and the details presented here may not apply to your personal situation. Always consult with a qualified healthcare provider regarding any questions or concerns you have about your health or treatment options. Reliance on this information is solely at your own risk.