Watery eyes, medically known as epiphora, occur when tears overflow due to excessive production or an obstruction in the tear drainage system. This condition is a common and often bothersome side effect experienced by individuals undergoing chemotherapy. Managing epiphora can significantly improve comfort and quality of life during treatment.
Understanding Watery Eyes During Chemotherapy
Chemotherapy can affect the eyes through several mechanisms, leading to increased tearing. Some chemotherapy drugs may directly impact the tear glands, causing them to produce excessive tears. Other medications can alter tear composition or damage the ocular surface, leading to dry eye symptoms that paradoxically trigger reflex tearing as the eye attempts to compensate for dryness.
A frequent cause of watery eyes during chemotherapy is the impact on the tear drainage system. Certain chemotherapy drugs, such as 5-fluorouracil and docetaxel, can cause inflammation or narrowing of the tear ducts, particularly the small channels called canaliculi. This narrowing, known as canalicular stenosis, prevents tears from draining properly into the nasal cavity, causing them to spill over the eyelids. When tear ducts are blocked, tears can also accumulate in the tear sac, increasing infection risk.
At-Home Care Strategies
At-home care strategies can help manage watery eyes caused by chemotherapy. Gentle lid hygiene is important to keep eyes clean and free of crust or discharge. Use a clean, soft cloth dampened with warm water to gently wipe eyelids and lashes, moving from the inner corner outwards. Use a separate clean cloth for each eye to prevent germ spread.
Warm compresses provide soothing relief and encourage tear drainage. Soak a clean cloth in warm (not hot) water, wring out the excess, and gently place it over the affected eye for 5 to 10 minutes. This warmth eases swelling and assists in clearing minor blockages within the tear ducts. Regularly performing tear duct massage, by gently rubbing the area near the inner corner of the eye, close to the nose, can help dislodge debris or mucus and promote drainage. Always wash your hands thoroughly before and after touching your eyes.
Preservative-free artificial tears are an effective strategy, even if eyes are already watery. Paradoxically, dry eyes can trigger excessive tearing as a reflex, and these drops help lubricate the ocular surface, reducing irritation and subsequent tearing. Avoid environmental irritants that can worsen watery eyes, such as smoke, wind, or harsh lighting. Wearing protective goggles or dark glasses outdoors can shield the eyes from these elements. During periods of significant eye irritation, temporarily avoid wearing contact lenses and eye makeup.
Medical Approaches and When to Seek Help
When home care strategies are not sufficient, medical interventions can provide further relief for chemotherapy-induced watery eyes. Your healthcare provider may prescribe eye drops to address underlying issues. Anti-inflammatory or steroid eye drops can reduce swelling and irritation, while antibiotic drops may be necessary if a bacterial infection is present.
For cases where watery eyes are caused by dry eye syndrome triggering reflex tearing, punctal plugs might be considered. These tiny plugs are inserted into the tear ducts to slow tear drainage, helping to keep the eye surface adequately moist. Punctal plugs can be temporary or semi-permanent. If tear duct blockages are significant and persistent, an ophthalmologist may recommend procedures to improve drainage. This could involve dilating the tear outflow tract or, in more complex situations, a surgical procedure like dacryocystorhinostomy (DCR) to create a new pathway for tears to drain. Temporary stent placement may also be explored to prevent duct blockages.
It is important to seek medical advice if watery eyes are accompanied by warning signs. These include persistent eye pain or discomfort, changes in vision such as blurriness or loss of visual clarity, or signs of infection like redness, swelling, pus, or discharge from the eye. Additionally, if watery eyes severely impact daily activities or if you experience sudden flashes of light or numerous floaters, immediate medical attention is advisable. Your healthcare team can diagnose the cause and recommend the most appropriate course of treatment.