Watery eyes, medically known as epiphora, occur when tears overflow onto the face. While often a temporary and harmless inconvenience, this symptom can sometimes signal more significant underlying health issues. In rare instances, excessive tearing can indeed be connected to certain cancers or conditions that affect the eye or its surrounding structures. This article explores the common causes of watery eyes, delves into the rare connections with cancer, and provides guidance on when to seek medical attention for persistent symptoms.
Common Causes of Watery Eyes
Most cases of watery eyes stem from common, non-cancerous conditions that either increase tear production or hinder tear drainage. Environmental irritants frequently trigger reflex tearing, where the eye produces extra tears to wash away substances like dust, smoke, or chemical fumes. Exposure to strong winds, cold temperatures, or bright light can also stimulate tear overflow.
Infections are another frequent cause of watery eyes. Conditions such as conjunctivitis, commonly known as pink eye, or styes can lead to inflammation and excessive tearing. Paradoxically, dry eye syndrome can also cause watery eyes; when the eyes lack sufficient lubrication, they reflexively produce an abundance of tears to compensate for the dryness.
Obstructions in the tear drainage system, known as blocked tear ducts, prevent tears from properly draining into the nose, causing them to well up and spill over. Allergies, whether seasonal or perennial, can irritate the eyes and result in watery, itchy sensations. Eyelid abnormalities, such as an inward-turning eyelid (entropion) or an outward-turning eyelid (ectropion), can disrupt the normal distribution and drainage of tears, leading to persistent watering.
Cancer and Watery Eyes: Understanding the Connection
While uncommon, watery eyes can be a symptom in specific cancer cases, primarily when tumors affect the structures involved in tear production or drainage. Cancer can involve the system that produces tears or, more commonly, the drainage system, preventing tears from draining properly. Tumors directly affecting the lacrimal gland, which produces tears, can cause excessive tearing. These include cancers like adenoid cystic carcinoma or lymphoma, which may also present with a lump or bulging of the eye.
Cancers of the eyelid, such as basal cell carcinoma or squamous cell carcinoma, can develop near the tear duct openings or along the eyelid margin. These growths can cause irritation or physically obstruct the tear drainage pathways, leading to watery eyes. Similarly, tumors on the conjunctiva, the clear membrane covering the white part of the eye, or other ocular surface tumors like melanoma or squamous cell carcinoma, can inflame the eye or block tear flow.
In rarer instances, cancers from other parts of the body can spread to the eye or the surrounding orbital structures, leading to symptoms like watery eyes, pain, or vision changes. Furthermore, certain systemic cancers or their treatments, including chemotherapy and radiation therapy, can indirectly impact tear production or drainage. Some chemotherapy drugs, for example, can block tear drainage passages, resulting in excessive tearing.
When to Seek Medical Attention
Seek medical attention if watery eyes persist or are accompanied by other concerning symptoms. If excessive tearing does not resolve on its own within a few days or weeks, a medical evaluation is advisable. Unilateral watery eyes, affecting only one eye, can be a more significant indicator of an underlying issue, especially if persistent.
Prompt medical attention is warranted for accompanying symptoms such as:
Pain in or around the eye
Changes in vision, such as blurriness, double vision, or sudden loss of vision
Swelling, redness, or tenderness around the eye or eyelid
A palpable lump or mass
Bleeding or unusual discharge from the eye
New moles or lesions on or around the eyelid that are changing in size, shape, or color
Systemic symptoms like unexplained weight loss, fatigue, or fever
Diagnostic Approach for Persistent Watery Eyes
When persistent watery eyes require medical investigation, a healthcare professional will typically begin with a thorough medical history and a physical examination of the eyes. This includes questions about the duration and nature of symptoms, as well as an assessment for any related health conditions. A detailed examination of the eye’s structures, often utilizing a slit-lamp microscope, allows for close inspection of the eyelids, conjunctiva, and cornea.
To assess the tear drainage system, specific tests can be performed. These include tear duct patency tests, such as the fluorescein dye disappearance test, where a dye is placed in the eye to observe how quickly it drains, or irrigation and probing, where a saline solution is flushed through the tear ducts to check for blockages.
If a mass or tumor is suspected, imaging studies become necessary. Computed tomography (CT) scans and magnetic resonance imaging (MRI) of the orbit can provide detailed views of the eye and surrounding tissues, helping to identify any abnormal growths. Should a suspicious lesion or mass be identified, a biopsy may be performed to obtain a tissue sample for definitive diagnosis. This involves microscopic examination of the tissue to determine if it is benign or malignant. Depending on the findings, a referral to specialists such as an ophthalmologist, an oculoplastic surgeon, or an oncologist may be made to ensure appropriate management.