Why Are My Eyes Tearing So Much?

By Michael J. Dodd, MD

Maryland Eye Associates

. http://marylandeyeassociates.com

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Why Are My Eyes Tearing So Much?

Tearing can be a source of frustration. Constant tearing can interfere with vision, and constantly wiping them, can be inconvenient and embarrassing.

The purpose of tears is to clean and lubricate the surface of our eyes. The tear film is composed of a mucus layer, an aqueous layer and a lipid layer, all of which must function properly, to provide a healthy ocular surface.

Tears can be categorized as basal, reflex and emotional tears. Basal tears keep adequate moisture levels on the eyes, allowing for clarity in vision. Reflex tearing occurs when the eyes are irritated. And lastly, emotional tears can occur in response to an emotional event.

Excess tearing can be related to excessive tear production (hyper-secretion) or poor drainage of the tear duct system (outflow obstruction).

Excessive tear production or hypersecretion, is typically related to irritation of the eyes due to external factors, including dryness, allergies, environmental irritants, scratches, inward-grown lashes, or poorly positioned eyelids.

The most common cause of excess tear production is related to dry eyes. As the ocular surface becomes dry, the eyes become uncomfortable, and this signals the glands to produce tears as a reflex. Counter-intuitively, persons with dry eyes have excess tearing. Dry eyes are especially more symptomatic during the winter months, as it becomes less humid. Therapy for dry eye syndrome can include lubricant eye drops and ointments, punctal occlusion (closing the ducts that drain tears out of the eye), or restasis and other prescription medications.

Allergies are another common source of excess tear production. Treatment for allergies typically involves a combination of topical and oral antihistamine medications. Eyelid inflammations, such as blepharitis, which affects the oily layer of the tear film, are another common source of tearing. Treatment for blepharitis includes eyelid hygiene, warm compresses, tear supplements, antibiotics and anti-inflammatory medications. Ocular irritation caused by eyelid malpositions can be corrected with various surgical procedures.

Tearing due to outflow obstruction occurs when the tear drainage system passageway becomes blocked. Similar to a clogged sink, the tears are not able to drain, and end up overflowing on to the cheek. There is an opening along the corner of each eyelid that collects the tears, follows a passageway, and eventually exits into the nose. A tear duct obstruction or narrowing of any of the passageways can be caused by aging changes, inflammation or infection, trauma or even the use of certain medications, such as chemotherapy agents. Tear outflow obstructions can be corrected through various procedures that aim to dilate, or create alternate pathways for the tears to drain.

Although tearing is important for our eyes, let's stop the crying, and start doing something about it.