Watery eyes (epiphora) can be a common and frustrating experience for older adults. This condition involves excessive tearing that overflows onto the cheeks, impacting comfort and vision. While some assume it’s a normal part of aging, epiphora can stem from various treatable causes. Understanding these reasons is the first step toward relief and improved eye health.
How Tears Normally Work
Tears are produced by lacrimal glands above each eye and are essential for eye health. These glands continuously produce a thin tear film that spreads across the eye’s surface with every blink, keeping it moist, smooth, and protected from irritants. The tear film consists of three layers: an oily outer layer to prevent evaporation, a watery middle layer for hydration and nourishment, and an inner mucus layer to help tears adhere to the eye.
After lubricating the eye, excess tears drain through tiny openings called puncta, in the inner corners of the upper and lower eyelids. From the puncta, tears enter small channels, flowing into tear ducts leading into the nasal cavity. This drainage system ensures tears are constantly refreshed and do not accumulate excessively.
Primary Causes of Watery Eyes in Older Adults
Dry eye syndrome is a common cause of watery eyes in older adults. Inadequate lubrication irritates eyes, triggering reflex overproduction of tears to compensate for dryness or poor tear quality. These reflex tears often lack the correct balance of oil and water, leading to rapid evaporation and continued irritation.
Blocked tear ducts (dacryostenosis) are another factor. With age, the tear drainage system can narrow or become obstructed, preventing tears from draining into the nose. This blockage causes tears to build up on the eye’s surface and spill over, creating constant watering.
Eyelid malpositions also contribute to epiphora. Ectropion occurs when the lower eyelid turns outward and sags away from the eye. This outward turning prevents the eyelid from effectively collecting tears and directing them towards the tear drainage system, leading to overflow.
Conversely, entropion involves the eyelid turning inward, causing eyelashes to rub against the eye’s surface. This constant irritation stimulates excessive tear production as the eye attempts to flush out the perceived foreign bodies. Both ectropion and entropion can develop due to changes in eyelid elasticity with aging.
Other Factors Causing Watery Eyes
Beyond age-related causes, other factors can trigger watery eyes. Environmental irritants cause eyes to water as a protective reflex. Exposure to smoke, wind, dust, pollen, or strong fumes can irritate the delicate eye surface, prompting increased tear production to wash away these substances.
Certain medications can also lead to watery eyes as a side effect. Some drugs, including those for glaucoma, chemotherapy agents, and common cold medications, may affect tear production or drainage. Review all medications with a healthcare provider if watery eyes become a persistent issue.
Eye infections or inflammation also contribute to excessive tearing. Conditions like conjunctivitis (pink eye) involve conjunctiva inflammation, leading to redness, discharge, and watery eyes. Blepharitis, an inflammation of the eyelid margins, can also cause irritation and excessive tearing.
When to Seek Medical Advice
While occasional watery eyes may resolve, persistent or bothersome tearing warrants medical evaluation. Consult an eye care professional if watery eyes are accompanied by pain, redness, or vision changes. Other concerning symptoms include eye discharge, a feeling of foreign body, or if home remedies don’t provide relief. A proper diagnosis is important to identify the cause and determine the most appropriate course of action.
Approaches to Managing Watery Eyes
Managing watery eyes involves addressing the underlying cause. For example, if dry eye syndrome is the culprit, artificial tears can help lubricate the eyes and reduce reflex tearing. For blocked tear ducts, warm compresses may help, but significant blockages might require medical procedures to open the drainage pathway.
Eyelid malpositions like ectropion or entropion often necessitate surgical intervention to correct eyelid position and restore tear drainage. For watery eyes caused by environmental irritants, avoiding exposure or wearing protective eyewear can be beneficial. Using humidifiers can also help maintain a comfortable environment for the eyes.
Gentle wiping of the eyes and avoiding rubbing can provide symptomatic relief. However, self-diagnosis and treatment are not recommended. Professional guidance from an eye care specialist is important for accurate diagnosis and a tailored treatment plan to manage watery eyes.