Watering eyes occur if too many tears are produced or if they cannot drain away properly.
The problem can affect anyone, but it’s most common in young babies and people older than 60. It can cause blurred vision, sore eyelids and sticky eyes.
See your GP or optician if you have persistent watering eyes or any lumps or swelling around your eyes.
What causes watering eyes?
A problem with the glands
Glands in the eyelids (Meibomian glands) normally secrete an oily substance that slows the evaporation of tears between blinks.
When these glands don’t function properly, known as Meibomian gland dysfunction (MGD), it can result in dry patches on your eyes. These become sore, and extra tears are produced as a reflex. This is the most likely cause of watering eyes.
Other problems that can cause extra tears to be produced include:
- the lower eyelid sagging away from the eye (ectropion) – this makes it difficult for tears to reach the drainage ducts
- eyelids that roll inwards (entropion)
- inflammation of the edges of the eyelids (blepharitis)
- blocked or narrowed tear ducts
- eye irritation (for example, from chemical fumes or grit)
- an eye infection, such as conjunctivitis
- an allergy
How are watering eyes investigated and treated?
Your GP may refer you to an optometrist (eye specialist) for an examination, if no obvious reason for your watering eye can be found.
Investigating the cause
If necessary, you may then be referred to an ophthalmologist (eye surgeon) for further investigation.
An ophthalmologist will look for blockages in your tear ducts, using local anaesthetic eye drops to help reduce any discomfort. This involves inserting a tiny probe into the narrow drainage channels on the inside of your eyelid to determine whether they are blocked. Fluid may also be injected into your tear duct, to see whether it comes out normally.
Another test involves placing a drop of special dye in each eye. If there is a significant amount left in your eyes after five minutes of normal blinking, your tear ducts may be blocked.
Scans of your tear ducts may sometimes be carried out. These can involve either injecting or placing special dyes into the tear ducts and then taking X-rays or other scans to help pinpoint the location of the blockage.
If you’re producing extra tears as a result of dry eye syndrome, you may be offered lubricating eye drops and advised to avoid activities that aggravate your symptoms.
Medication may be needed if the cause is an allergy or infection, and surgery may be needed if a tear duct is blocked.
If watering eyes aren’t interfering with your life, you may choose not to have treatment.
Read more about treating watering eyes.
Treating watering eyes
Treatment for watering eyes isn’t always necessary. Treatment depends on how severe the problem is and what’s causing it.
Measures you can try yourself
If the underlying cause is dry eye syndrome, try avoiding reading, watching TV and using a computer – you’re likely to blink less during these activities, which can make symptoms worse.
The use of lubricating eye drops can help ease the discomfort of dry eye. These can be bought over the counter from a pharmacy and your healthcare professional can advise which product is best for you.
It might help to hold a warm, damp, clean cloth over the affected eye for five minutes and at the same time, gently massage your eyelids with the cloth to loosen any material that might be blocking the eye glands.
If a bacterial infection such as conjunctivitis is causing watering eyes, your GP may prescribe a course of antibiotics. If they suspect a virus is the cause, you may be advised to wait for a week or so to see if it resolves itself.
If your eyes are watering because of an allergy, antihistamine medication may be prescribed to help reduce the inflammation.
In cases where irritation is caused by an inward-growing eyelash or a foreign object, such as a piece of grit, these can be removed by your GP or eye specialist.
If your lower eyelid rolls inwards (entropion) or sags outwards (ectropion), a minor operation carried out under local anaesthetic may be recommended. The most common procedure involves tightening the tendon that holds the outer eyelid in place to give it extra support. See the page on treating ectropion for more information.
Surgery for blocked tear ducts
Tear ducts allow excess tears to drain away. If a blocked tear duct is causing watering eyes, it can be treated with surgery.
If you have an infection in your tear sac (where excess tears from your eyes drain into), it will need to be treated with antibiotics first, before surgery. Left untreated, the infection could spread to your eye socket.
Dacryocystorhinostomy (DCR) is a common surgical procedure used to treat blocked tear ducts. It involves creating a new channel from the tear sac to the inside of your nose. This channel allows tears to bypass the blocked part of your tear duct.
Surgery generally involves removing a very small piece of bone from the side of your nose, allowing the tear sac to drain directly into the nasal cavity. This can be done externally, starting with a small incision in the skin on the side of your nose, or from inside the nose using an endoscope. An endoscope is a narrow, flexible tube with a light at the end.
A very thin silicone tube is often inserted to keep the channel open. Within a few months, the tube will be removed and the channel should stay open without it.
The DCR procedure is carried out either under general anaesthetic or under local anaesthetic with some sedation, and takes up to an hour to perform.
If the tear duct is not blocked, but just narrowed, a thin tube with a small balloon at the end (a balloon catheter) can sometimes be used to widen it.
Most DCR surgery is carried out as a day case procedure, which means you can go home the same day. You will be given instructions to follow when you are discharged – for example, not to blow your nose for one week after surgery. You may also be given some eye drops or ointment to use to prevent infection and inflammation, as well as a nasal spray.
There could be some bruising and swelling around your nose and eye, which should improve over a few days or weeks. You may also experience nosebleeds for a few days.
If the drainage channels on the inside of your eye (canaliculi) are completely blocked by tears, an operation to drain them may be required. This usually involves inserting a small glass tube (called a Lester Jones Tube) to drain the tears.
Treating watering eyes in babies
Watering eyes often improve in babies without the need for treatment.
Massaging the tear ducts may help to dislodge tears that have collected in the upper part of your baby’s tear duct, as well as encouraging the tear duct to develop. This can be done by applying light pressure with your first (index) finger and massaging from the corner of your baby’s eye towards their nose. Repeat the massage several times a day for a couple of months. Before massaging, wash your hands.
You can also soak a cloth with warm water and hold it against your baby’s eye. This may encourage the tears to drain. If your baby has an eye infection (conjunctivitis), this may need to be treated with antibiotic eye drops.
In 9 out of 10 cases, the tear duct opens by itself before your baby is one year old. However, if your child is over a year old or has repeated infections caused by the blocked tear duct, a procedure may be recommended to open their tear duct using a probe. This will be carried out under general anaesthetic. Only a very small number of babies with watering eyes require this type of treatment.
Very occasionally, a DCR operation is required (see above).