Watery Eyes

An eye that waters is making more tears than its drains can carry away. That happens for one of two reasons: too many tears are being made, or the tears cannot drain. The most common cause is the first, and the usual reason for it is a surprise: the eye is dry.

Choose a cause below and press Play.

Too many tears

• Dry eye. When the tear film breaks up, the dry surface signals the tear gland, which answers with a rush of watery reflex tears. They are thin and run straight off, so the eye is dry again minutes later. This kind of watering comes and goes, and is worse in wind, cold air, and when reading, driving or using a screen. See What Is Dry Eye?
• Irritation of the eyelids or surface: blepharitis, an in-turned lash, something in the eye, or a scratch.
• Allergy, where itching is the main complaint.
• Infection (pink eye), with redness and discharge.

Tears that cannot drain

Tears leave through two small openings at the inner corner of the lids, run through fine channels into the tear duct, and end up in the nose.

• A narrowed drain opening. The openings can tighten with age or long-standing lid inflammation.
• A blocked tear duct. The duct further down can block, most often with age. The watering is then constant, indoors and out, often with stickiness or mucus, and sometimes with repeated infections at the inner corner.
• A loose or out-turned lower lid. The lid needs to sit snugly against the eye so the drain opening touches the tears, and so each blink can pump tears into it. A slack lid, or one weakened by a facial nerve palsy, leaves tears pooling and spilling over.

How the cause is found

Your doctor examines the tear film, the lids and their position, and the drain openings at the slit lamp. A drop of dye shows how quickly tears leave the eye. If a blockage is suspected, the drain can be gently rinsed with salt water in the office: if it is open, you taste the salt water at the back of your throat.

What fixes it

• Dry eye: treating the dryness stops the reflex tears. It can seem odd to put tears into a watery eye, but artificial tears and lid care are the treatment.
• Lid irritation, allergy or infection: treating the cause.
• A narrowed opening: it can be widened in the office.
• A blocked tear duct: an operation makes a new passage from the tear channels into the nose. It is done by an eyelid and tear duct specialist, and your doctor can refer you.
• A loose lid: a small operation tightens the lid so it sits against the eye again.

Call the office if

• One eye starts watering constantly, especially with a sticky discharge
• The inner corner of the lids becomes red, swollen and tender
• A watery eye is also painful, red or light-sensitive, or the vision drops. See When to Call the Same Day.

Questions worth asking

• Is my eye making too many tears, or not draining them?
• Would treating dry eye be enough?
• Is my tear duct open?