OPTHALMIC CONDITIONS
Epiphora (Watery Eyes)
A constant process of tear production and drainage
Tears and the lacrimal system
In the eye there is a constant process of tear production and drainage. Tears are crucial for lubricating the eye’s surface and are spread across the ocular surface through blinking. Both a deficiency in tear production and excessive tear production can impact a patient’s daily life and potentially affect vision.
The lacrimal apparatus is the collection of anatomical structures (lacrimal glands, lacrimal puncta, lacrimal ducts, lacrimal sac, and nasolacrimal duct), responsible for the proper production and drainage of tears. The importance of the proper functioning of the lacrimal system is significant, and there are numerous pathological conditions that can create problems.
What is epiphora (watery eyes) and what are its major causes?
Watery eyes, or epiphora, is the overflow of tears on the face (excessive secretion and uncontrolled flow onto the cheeks). Dry eye syndrome and chronic blepharitis are the most common causes of watery eyes. Additionally, dysfunction of the meibomian glands, which produce poor – quality tears, certain allergies, trichiasis, alteration in the normal anatomical position of the eyelids, entropion or ectropion, dysfunction of the lacrimal pump, or obstruction of the nasolacrimal duct are other causes that can lead to tears pooling in the eye.
How is epiphora (watery eyes) treated?
Epiphora (watery eyes) is considered a complex issue that significantly affects the quality of life and daily activities of many patients. A thorough and detailed clinical examination is necessary to accurately identify the real underlying causes and determine the most appropriate treatment approach.
If epiphora (watery eyes) is caused by a “turned – in” eyelash, it should be removed. If the primary cause is dryness or dry eye syndrome, treatment with artificial tears and other formulations (e.g. oral medications) is recommended. In the case of infection or inflammation, medicinal eye drops are prescribed. For a simple narrowing of the lacrimal drainage system, microsurgical techniques are applied (e.g. dacryoplasty).
Finally, when nasolacrimal duct obstruction is detected, the modern surgical technique that provides a solution is dacryocystorhinostomy (DCR). This procedure bypasses any obstruction or narrowing of the nasolacrimal duct, stopping the bothersome watery eyes. Dacryocystorhinostomy can be performed in 2 ways, and the results are excellent with high success rates:
Externally (with a small incision in the skin)
Endoscopically (through the nose, without skin incision)
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