Brief overview
- Description: Leakage of lacrimal fluid over the lid margin often with further symptoms like foreign body sensation, burning sensation, eye redness.
- Causes: Among other things, age-related changes, foreign bodies in the eye, allergies, infections of the eye or upper respiratory tract, underlying diseases such as diabetes, environmental stimuli (gases, vapors, smoke).
- Treatment: Depending on the cause, including “artificial tears,” allergy medications, specific medications to treat underlying conditions.
- When to see a doctor? Prolonged tearing, recurrent watery eyes, hard mass in or around the lacrimal duct.
- Diagnosis: Medical history, eye examination by ophthalmologist, possibly further examinations for underlying diseases.
- Prevention: Ensure a “good” eye climate (ventilate rooms regularly, avoid drafts), drink enough, take breaks from computer work, have underlying diseases treated.
Watery eyes: Description
Watery eye, also called watery eye or epiphora, is when tear fluid runs down the edges of the eyelids. “Normal” reasons for this are emotional such as sadness or joy. In some cases, however, diseases or changes in the eyes are behind it.
What are the causes of watery eyes?
When the balance between tear production and tear removal is disturbed, watery eyes occur. This has numerous different triggers. The most common causes of a watery eye are age-related changes, allergies and – paradoxically – too dry eyes.
In addition, foreign bodies (such as eyelashes turned inward) are a reason. They irritate the eyes and cause them to water, as does an eyelid that is turned outward (ectropion).
Infections of the eyes (for example conjunctivitis caused by bacteria or viruses), chronic infections of the lacrimal sacs and other diseases such as diabetes mellitus are also possible triggers of watery eyes. They are among the serious causes that are better clarified by a doctor.
Infections of the upper respiratory tract and allergies affecting the nose or eyes are also frequent triggers of watering eyes.
Basically, three main mechanisms can be distinguished in the development of watery eyes:
- Functional disturbance of the lacrimal drainage (e.g. disturbances in the function of the eyelid)
- Anatomical changes of the lacrimal ducts (such as blockage of the lacrimal ducts)
- Overproduction of lacrimal fluid (such as irritation of the eyelids, conjunctiva, cornea)
The dry eye
Subsequently, with the help of the tear pumps, the fluid migrates via tear ducts of the upper and lower eyelid into the lacrimal sac, from where it reaches the nasal cavity via the nasolacrimal duct.
Indirectly, slack blinking and poorly functioning lacrimal glands result in less tear fluid and thus initially dry eyes. Because the tear film serves as a natural lubricant for the blink, the eyelids irritate the dry cornea of the eye with each blink.
In addition, the eyes are more susceptible to infections when the healthy tear film with its germicidal substances is missing. Small particles also stick more easily and irritate the eyes even more. The lacrimal glands then produce so-called reflex tears: watery eyes are the result.
Causes of dry eyes
The following is an overview of the triggers of dry eyes and, subsequently, watery eyes:
- Age- and/or hormone-related decrease of tear fluid
- Environmental factors (ozone, exhaust fumes, heating air, dry room air)
- Allergies
- Contact lenses
- Medications (for example cytostatics, beta blockers, antihistamines, birth control pills)
- Internal diseases such as diabetes mellitus, thyroid disease, inflammatory rheumatism
- Stroke or paralysis of the facial nerves due to other causes, which make intact blinking difficult
Symptoms accompanying dry eyes to watery eye
- Foreign body sensation in the eye, burning, scratching
- Feeling of pressure in the eyes
- Pain
- Swelling of eyelids
- Mucus secretion, sticky eyelids
- Reddening of conjunctiva
- Impaired vision
- glare, photophobia
Watery eyes in old age
Most of the people who visit the ophthalmologist because of watery eyes are older people – especially women. The age-related change in hormones during menopause, but also age-related symptoms unrelated to gender, often lead to functional disturbance of tear drainage.
A complex musculature and surrounding connective tissue ensure the stability and function of the eyelid, the lacrimal gland and the tear pump. If the musculature and connective tissue become weaker due to hormonal changes or age, the tear volume can no longer be properly regulated. The direct consequence of a disturbed tear pump or blocked tear ducts is watery eyes.
What to do in case of watery eyes?
It is advisable to have watery eyes medically examined to rule out serious underlying diseases and prevent possible secondary diseases. If the ophthalmologist determines that environmental factors are the cause of dry eyes and thus watery eyes, many complaints can often be alleviated with these simple tips themselves:
- Ventilate regularly and ensure that the room climate is not too dry (possibly set up a humidifier).
- Avoid drafts, car blowers, air conditioners.
- Refrain from smoking and avoid smoky rooms.
- Drink sufficient alcohol-free and caffeine-free fluids (water, mineral water, tea).
- When working at a computer screen for a long time, make sure to blink frequently to distribute tear fluid over the surface of the eyeball again and again. Take breaks from work more often. It may be useful to use “artificial tears”.
- Get enough sleep – tired eyes are often irritated, itchy or burning.
- Clean the edges of your eyelids, especially to remove makeup.
- As a contact lens wearer, be sure to take longer breaks from wearing them and clean them thoroughly and regularly. If necessary, talk to your doctor about a different lens style (hard, soft lenses) to avoid watery eyes as a result of irritation.
What remedies help?
Which medicines and other remedies may still help with watery eyes depends on the cause. For example, infections of the eye can be treated with medication and eyelid malpositions can be treated surgically. Malfunctions of the lacrimal apparatus can be corrected by the doctor using certain ophthalmological methods.
Watery eyes as an accompanying symptom of diabetes mellitus often disappear when the physician correctly adjusts the patient to blood sugar-lowering medication (oral antidiabetics, insulin).
In menopausal women, hormone replacement therapy may help to reduce the hormonal imbalance and thus alleviate its accompanying symptoms (such as watery eyes). However, the benefits and risks of such hormone therapy must be carefully weighed against each other.
Watery eyes: examination and diagnosis
The ophthalmologist will discuss your medical history with you. He will ask you about the nature and duration of your symptoms and any concomitant diseases. This often provides important information about the possible causes of watery eyes.
Further clues are provided by the anatomy of your facial skull, the lacrimal glands and tear sacs, as well as the condition, position and mobility of the eyelids. Also informative are often functional and diagnostic tests such as secretion tests (to measure the amount of tear fluid).
Further tests may be necessary, for example if the doctor suspects a general disease such as diabetes is behind the watery eyes.
Watery eyes: When to see a doctor?
On the one hand, watery eyes may cause long-term damage (also to vision), regardless of the cause. On the other hand, there may be serious underlying diseases behind the symptom of watery eyes, which should ideally be treated.
Watery eyes: prevention
Many of the tips that can be used to treat watery eyes yourself already help preventively, even if no dry or watery eyes have occurred so far. Measures for prevention are in particular:
- Create a good room climate with ventilation and, if necessary, air humidification, especially during the heating season.
- Avoid smoke and vapors in the air, if necessary wear protective goggles at work
- Avoid drafts, blowers, air conditioning
- Take breaks when working at computer screens, pay attention to blinking
- Get enough sleep
- Remove make-up completely, especially before going to bed
- Take breaks from wearing contact lenses, clean contact lenses properly
