Understanding and Addressing the Causes of Epiphora

sohraab yadav
Oct 6
3 min read

Epiphora, commonly known as watery eyes, is a condition where tears overflow onto the face instead of draining normally through the tear ducts. This can be uncomfortable and sometimes embarrassing, affecting daily activities and vision. Understanding the reasons behind this condition is essential for effective management and relief.

Epiphora Causes and Treatment

Epiphora can result from various underlying issues. The tear drainage system includes the lacrimal glands, puncta (small openings on the eyelids), canaliculi (small channels), lacrimal sac, and nasolacrimal duct. Any disruption in this system can cause tears to accumulate and overflow.

Common causes include:

Blocked tear ducts: This is one of the most frequent reasons for epiphora. Blockages can be due to infections, inflammation, or physical obstructions.
Excessive tear production: Sometimes, the eyes produce more tears than usual due to irritation from wind, smoke, or allergies.
Eyelid problems: Conditions like ectropion (outward turning of the eyelid) or entropion (inward turning) can prevent proper tear drainage.
Infections and inflammation: Conjunctivitis or blepharitis can cause swelling and increased tear production.
Foreign bodies: Dust or small particles in the eye can trigger excessive tearing.

Treatment depends on the cause. For blocked tear ducts, warm compresses and gentle massage may help. Infections require antibiotics or antiviral medications. Eyelid problems might need surgical correction. Artificial tears can soothe irritation, and avoiding allergens or irritants can reduce symptoms.

Close-up view of an eye with visible tear overflow — Tear overflow in epiphora condition

What causes watery eyes in children?

Watery eyes in children are often due to congenital issues or infections. The most common cause is a blocked nasolacrimal duct, which is present at birth in many infants. This blockage usually resolves on its own within the first year of life but may require intervention if persistent.

Other causes in children include:

Eye infections: Bacterial or viral conjunctivitis can cause redness and tearing.
Allergies: Seasonal allergies can lead to watery eyes and itching.
Irritants: Exposure to smoke, dust, or strong winds can trigger excessive tearing.

Parents can help by gently massaging the area near the tear duct to encourage drainage. If symptoms persist or worsen, consulting a paediatric ophthalmologist is recommended.

Eye-level view of a child’s eye with slight redness and tear accumulation — Watery eyes in children due to blocked tear duct

Diagnosing Epiphora

Proper diagnosis is crucial for effective treatment. An eye specialist will perform a thorough examination, including:

Visual inspection: Checking for eyelid abnormalities or signs of infection.
Fluorescein dye test: To observe tear drainage and identify blockages.
Irrigation test: Flushing the tear ducts to check for obstructions.
Imaging: In some cases, imaging like dacryocystography may be used to view the tear drainage system.

Early diagnosis helps prevent complications such as infections or chronic discomfort.

Managing and Preventing Epiphora

Managing epiphora involves addressing the root cause and adopting preventive measures:

Maintain eye hygiene: Regularly clean eyelids and lashes to prevent infections.
Avoid irritants: Limit exposure to smoke, dust, and allergens.
Use protective eyewear: Sunglasses can shield eyes from wind and debris.
Apply warm compresses: This can relieve blockages and soothe irritation.
Follow medical advice: Use prescribed medications and attend follow-up appointments.

In some cases, surgical procedures like dacryocystorhinostomy (DCR) may be necessary to create a new tear drainage pathway.

High angle view of eye care products including eye drops and warm compress — Eye care products for managing epiphora

For more detailed information on the causes of epiphora, visiting specialised eye care websites can provide valuable insights and guidance.

Living with Epiphora

While epiphora can be bothersome, many people manage it successfully with proper care. It is important to monitor symptoms and seek professional help if tearing is accompanied by pain, vision changes, or persistent redness.

Regular eye check-ups can help detect issues early. Lifestyle adjustments, such as avoiding known irritants and practising good eye hygiene, contribute significantly to comfort and eye health.

Understanding the condition empowers individuals to take control and improve their quality of life despite the challenges posed by epiphora.