Epiphora - Treating watering eyes

Treatment for watering eyes is not always necessary. Treatment depends on how severe the problem is and what is causing it.

Treating irritation

If irritation is causing your eye to water, treatment will usually focus on removing the source of irritation.

If an infection, such as conjunctivitis, is causing watering eyes, your GP may prescribe a course of antibiotics if they feel the infection is due to bacteria. 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 due to an allergy, a type of medication called an antihistamine 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.

If your lower eyelid turns inwards (entropion) or 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 treating ectropion for more information.

Surgery for blocked tear ducts

Tear ducts are the tubes through which excess tears drain away. If a blocked tear duct is causing watering eyes, it can be treated with surgery.

However, the decision to have treatment or not is yours. If your watering eye is not bothering you, surgery may not be necessary.

If your eye is sticky or if there is a lump below your eye, treatment is usually recommended to prevent your eye from becoming infected. If your symptoms are particularly severe and your watering eyes are interfering with your vision for driving, reading and sports, treatment may be appropriate.

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 and then most likely with surgery. Left untreated, the infection could spread to your eye socket.

Dacryocystorhinostomy (DCR)

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 by making 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). The bone can be removed surgically or by using a laser.

A very thin silicone tube is usually inserted to keep the channel open. After a couple of months, the tube will be removed and the channel should stay open without it.

The DCR procedure is usually carried out under general anaesthetic 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.

After surgery

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 2 weeks 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. However, these are usually minor and should stop in due course.

Blocked canaliculi

If the drainage channels on the inside of your eye (canaliculi) are completely blocked by tears, an operation to drain them may be required, usually involving a small glass tube (called a Lester Jones Tube) being inserted to bypass the blockage and 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. 

Probing

In 9 out of 10 cases, the tear duct opens by itself before your baby is one. 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 dacryocystorhinostomy (DCR) operation is required (see above).