Treatment for watery eyes caused by blocked tear ducts

While it is normal for liquid to spill from your eyes when you’re crying, some people find that one or both of their eyes is unusually watery most of the time.

Your eyes constantly produce liquid for lubrication and protection but you don’t normally notice this because it is drained away by your tear ducts — tiny tubes that run down the side of your nose to deliver the fluid to your nasal cavity.

Watery eyes (or epiphora) usually occurs when one or more of your tear ducts become blocked. Blockages can be caused by various factors including injury, infection or chronic use of eye drops.

Some people with blocked tear ducts develop recurrent infections, a discharge, pain, conjunctivitis or even abscesses around the inner corner of their eye.

Diagnosis of blocked tear ducts

Dr Parker will carefully examine your eyes and determine whether your watery eye is actually due to tear duct blockage or some other cause. He will inject salty water through the tear duct during your consultation. This is not painful. If the tear duct is working correctly, fluid should pass in to your nose and throat. If the tear duct is blocked, the fluid will not pass.

He will want to rule out allergies, dry eye, infection, in-growing eyelashes, or an abnormal position of the eyelid. There are also some facial nerve problems that can result in a watery eye.

He may order imaging of your nasal passages.

Tear duct surgery can cure a blockage

If a watery eye is constantly bothering you or causing problems, Dr Parker may recommend tear duct surgery (dacryocystorhinostomy or DCR). This procedure helps bypass a tear duct obstruction by creating a new permanent drainage pathway.

Tear duct surgery is a common a procedure and, when performed by a skilled surgeon, has a high level of patient satisfaction and a high success rate.

How tear duct surgery is performed

The surgery is done in one of two ways:

  1. Externally, by making small incisions on the side of your nose which are then closed with tiny sutures
  2. Internally by accessing the area using a nasal endoscope placed inside the nose
Dr Parker will discuss the options with you when planning the surgery.

He performs tear duct surgery (DCR) as a hospital procedure.

After instilling antiseptic drops into your eye, and injecting local anaesthetic around the eye and nose, he makes a small hole in the bone to create a new pathway for the tears.

He may also place a thin silicone tube underneath the skin and leave it there for several weeks to months to aid tissue healing. Sometimes a permanent placement of tubes is required.

Risks of tear duct surgery

Complications with tear duct surgery are rare but they may include:

  • Persistence of watery eye, requiring a second operation
  • Post-operative nosebleeds
  • Infection
  • Visible scarring on the side of the upper nose
  • Complications associated with the silicone tube
  • Occasional reflux of air into the eye while blowing the nose.

Rare risks associated with any eye surgery include impaired blinking or closing of the eyelid, injury to the eye resulting in vision loss, altered eye movements, or injury to the sinuses.

After your surgery

After an external DCR, you may have some swelling or bruising. You will have small sutures on the side of your nose which Dr Parker will remove at a follow-up visit.

After an endoscopic DCR procedure there are usually no visible external signs of swelling or bruising, and no sutures. Instead, the inside of your nose will be packed with gauze.

Any discomfort during the recovery period is usually minimal and can be managed with over-the-counter pain medication such as paracetamol.

For the first 10 days following surgery, you need to avoid strenuous physical activities that could potentially increase nasal bleeding. Most people experience a feeling of nasal blockage for about a week, which can be relieved with nasal sprays.

Dr Parker may also prescribe eye drops to reduce inflammation of the tear duct. He will need to see you again in about four weeks to check that the results are satisfactory.

If you think a blocked tear duct may be causing your watery eye, ask your GP for a referral to Dr Parker.

If you think a blocked tear duct may be causing your watery eye, ask your GP for a referral to Dr Parker.