Excessive tearing (lacrimation) or defective drainage of tears may cause epiphora, with resultant chronic annoyance, irritation and social awkwardness.
Excessive tearing may be due to any number of causes and may be a temporary or chronic condition.
Dry eye
Side effect of some medications
Skin disease of or around the eyelids
Diseases of the glands in the eyelids
Refractive surgery
Allergies
Infrequent blinking due to computer or video screen usage
Prolonged contact lens wear
Immune system disorders
Chronic inflammation (conjunctivitis)
Exposure keratitis (eyelids do not close completely during sleep)
Eyelid malposition or malfunction, which impairs the ability of the blinking eyelids to direct tears into the normal draining tear ducts (nasolacrimal ducts).
Narrowing of the nasolacrimal drainage system at the punctae, canaliculi, lacrimal sac, nasolacrimal duct, or within the nose.
Treatment
Treatment of excessive tearing depends on the underlying cause and may need to be managed as a chronic condition.
There are a variety of prescription and non-prescription eye drops which may reduce ocular irritation or increase basic tear production, and thus reduce symptoms of dry eye.
Lacrimal plugs may be used as a temporary measure to plug the drainage openings at the inner corners of the eye to improve moisturization of the eyes for those with excessive tearing due to dryness. These are inserted in the office, with minimal discomfort to the patient. This process is reversible but in severe cases, permanent plugs may be recommended. In some cases, a punctal or canalicular surgery may be considered to reduce drainage.
When tearing is due to eyelid malposition or malfunction, surgery is generally successful in improving eyelid position and function and thus reducing tearing.
When tearing is due to obstruction within the nasolacrimal drainage apparatus, surgery is generally successful in improving drainage and thus reducing tearing.
