Watery Eyes (Epiphora): Causes

Pathogenesis (development of disease)

In watery eyes (epiphora), tear production exceeds outflow capacity. Increased tear production due to, for example, emotional factors (grief, pain), inflammation, local irritation by foreign bodies, wind, cold, etc.

Outflow obstruction may occur due to local irritation or blocked tear ducts.

Etiology (causes)

Biographic causes

  • Lagophthalmos (incomplete eyelid closure).
  • Altered tear composition
  • Age – increasing age: mostly women due to the age-related change in hormones during menopause → functional disturbance of tear drainage.
  • Hormonal factors – menopause
  • Occupations with intensive screen work → reflex tears, which are a reaction to the dryness of the ocular surface.

Behavioral causes

  • Nutrition
    • Hot spices
  • Psycho-social situation
    • Grief
  • Onion cutting: Allicin is released when cutting onions and irritates the eyes.

Disease-related causes.

Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99).

  • Stenosis (narrowing) of the lacrimal duct.

Respiratory system (J00-J99)

  • Flu-like infection (common cold) → swollen mucous membranes prevent the lacrimal duct from draining the tear fluid
  • Rhinitis (cold)
  • Rhinitis allergica (RA) (synonyms: allergic rhinopathy; allergic rhinitis; pollen-related allergic rhinitis, hay fever, hay fever, or pollinosis) – symptomatic hypersensitivity reaction of the nose induced by IgE-mediated inflammation of the nasal mucosa (rhinitis) as a result of allergen exposure.
  • Sinusitis (sinusitis).

Eyes and eye appendages (H00-H59).

  • Acute open-angle glaucoma*
  • Allergic eye irritation due to perfumes
  • Allergic conjunctivitis (inflammation of the conjunctiva)
  • Age-related dacryostenosis (tear duct stenosis).
  • Eye infections including canaliculitis (inflammation of the tear ducts (canaliculus superior or inferior), for example, by infection with fungi, bacteria or viruses).
  • Dacryocystitis – inflammation of the lacrimal sacs; clinical picture: pain, redness and the formation of edema in the affected region, as well as severe watering eyes and vasodilatation of the conjunctiva (conjunctiva).
  • Ectropion – acquired malposition of the eyelid with an outward rotation; most often it is the lower eyelid.
  • Idiopathic age-related stenosis of the nasolacrimal duct ((narrowing of the nasolacrimal duct).
  • Keratitis* (corneal inflammation), unspecified [bacteria (e.g., Staphylococcus aureus, Streptococcus pneumoniae), viruses (herpes simplex), mycoses (especially after antibiotic therapy, or glucocorticoid eye drops), parasites (e.g. E.g., amoebae (amoebic keratitis); mostly indirectly via contaminated contact lens cases and care products or subsequently contaminated contact lenses); chemical, physical, mechanical; neurological]
  • Conjunctivitis, acute (conjunctivitis) (infectious conjunctivitis; viral conjunctivitis/keratoconjunctivitis epidemica).
  • Conjunctivitis sicca (dry eye) → reflex tears, which are a reaction to dryness of the ocular surface.
  • Trichiasis – inward turning of the eyelashes.
  • Ulcus corneae* – corneal ulcer of the eye, which can occur as a complication in the course of keratitis (inflammation of the cornea).
  • Uveitis anterior* – inflammation of the anterior region of the uvea (middle eye skin), especially the iris (iris) and the ciliary muscle.

* Eye pain and redness are in the foreground here.

Endocrine, nutritional and metabolic diseases (E00-E90).

  • Diabetes mellitus – leads to dry eyes, which in turn give rise to reflex tears (i.e., reaction to dryness of the ocular surface)

Psyche – nervous system (F00-F99; G00-G99).

  • Facial paresis – paresis (paralysis) of muscles innervated by the facial nerve, consequently, part of the facial musculature is paralyzed

Injuries, poisoning and other consequences of external causes (S00-T98).

  • Foreign body

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99)

  • Pain

Medication

  • Eye drops containing echothiophate, epinephrine or pilocarpine.
  • Medications that can lead to dry eye syndrome (keratoconjunctivitis sicca)

Environmental pollution – intoxications (poisoning) (including the issue of dry eyes and consequently reflex tears).

  • Work on the computer screen (screen work)
  • Intensive television
  • Car fan
  • Ozone, e.g. from copiers and printers
  • Irritating chemicals
  • Dry indoor air due tooverheated rooms, underfloor heating, air conditioning.
  • Insufficient or incorrect lighting
  • Environmental pollution (e.g. dust).
  • Cigarette smoke

Further

  • Ill-fitting glasses