Watery eyes (epiphora) (synonyms: Ocular discharge; lacrimation; watery eye; watery eye; ICD-10-GM H04.2: Affections of the lacrimal apparatus: epiphora), tear production exceeds drainage capacity, resulting in leakage of lacrimal fluid over the lid margins.
Clinical Anatomy
The lacrimal apparatus (Apparatus lacrimalis) serves to produce, transmit, and drain tears:
- Each eye has two lacrimal tubules that originate from the medial portion of the two eyelids (punctum lacrimale superius (superior lacrimal punctum) and punctum lacrimale inferius (inferior lacrimal punctum)). These join to form the common lacrimal duct: the tears then “run” into the lacrimal sac (saccus lacrimalis).
- The nasolacrimal duct (lat. Ductus nasolacrimalis) connects the lacrimal sac with the nose and opens into the inferior turbinate (concha inferior).
A watery eye occurs when tear production is too high or drainage is insufficient, or even a combination of both.
Even in infants, watery eyes can occur. Spontaneous opening of the tear ducts during the first weeks of life will correct the problem.
Teary eyes can be a symptom of many diseases (see under “Differential diagnoses”). Common causes of lacrimation are upper respiratory tract infections, allergic rhinitis, and dry eyes. The latter are reflex tears, which are a reaction to dryness of the ocular surface.
Sex ratio: women (especially menopausal) are more commonly affected than men.
Frequency peak: The disease occurs more frequently in older age.
Course and prognosis: In children, watery eyes may be due to conjunctivitis (inflammation of the conjunctiva). In the elderly, watery eyes are often due to local irritation or clogged tear ducts.Watery eyes should in any case be clarified by an ophthalmologist (see also under “Symptoms – complaints”: Warning signs (red flags)). Serious underlying diseases must be excluded or treated.
