As the weather turns chilly, more people notice increased excessive tearing. This condition, known as epiphora, can be uncomfortable and disruptive to daily life, although it is not usually serious. While many associate epiphora with aging, some people experience symptoms from birth. In most cases, it resolves naturally over time, but when it occurs in adulthood, it may be linked to various underlying causes.
What is Epiphora?
Epiphora, or excessive tearing, happens when the tear glands produce abnormal tears or when the tear ducts become blocked, preventing proper drainage. This condition can irritate the eyelids and surrounding eye tissues, sometimes leading to inflammation. While epiphora is often seen as an age-related condition in older adults, it can also affect newborns and children.
What Causes Epiphora?
Around 20-40% of epiphora cases are linked to a narrowing of the tear ducts due to aging or medications. Though some cases are congenital, most blockages are acquired, often in the nasolacrimal duct. This blockage is typically caused by degenerative changes in the membrane that lines the duct. Environmental factors, such as windy weather, can also irritate the eyes’ surface, leading to excessive tearing.
Discomfort in Daily Life
Epiphora is more than just an inconvenience—if left untreated, it can severely disrupt daily activities. Tears accumulating on the eye’s surface can blur vision, making it difficult to see clearly. Rubbing or wiping the eyes can irritate the cornea, potentially leading to other eye conditions. In more severe cases, the skin around the eyes may become inflamed and even develop dermatitis.
Dry Eye Syndrome as a Primary Cause
Extended hours of computer use, lack of sleep, stress, and dry indoor environments are major contributors to dry eye syndrome, a leading cause of epiphora. When the eyes become dry, the eyelids may shrink, causing eyelashes to irritate the eyes’ surface. Alternatively, the eyelids may sag, disrupting the natural flow of tears. Tears usually act as a protective barrier for the eyes, but when dry eye syndrome damages this barrier, the eyes become more sensitive to irritants, triggering excessive tearing.
Epiphora in Babies
About 5-6% of newborns have a thin membrane covering the end of the nasolacrimal duct, which can block the tear drainage pathway. This condition, known as congenital nasolacrimal duct obstruction, typically appears around one month after birth and leads to symptoms such as excessive tearing and eye discharge. In many cases, it resolves naturally without the need for treatment.
More Common in Women
Epiphora is more prevalent in women, especially those of East Asian descent, who naturally tend to have narrower tear drainage pathways. Frequent use of eye makeup can also contribute to epiphora by causing the buildup of foreign particles or irritants in the tear ducts, leading to blockages. To reduce the risk, makeup should be thoroughly removed using a gentle remover and a double cleanse to ensure the area is spotless.
Early Treatment is Key
Early intervention is crucial in managing epiphora and preventing the condition from worsening. If you notice an increase in tear production, you should visit an ophthalmologist for a tear duct flushing test to check for any issues with your tear ducts. This test involves injecting a saline solution into the tear duct and observing how well the fluid flows. The results are available immediately. The doctor may prescribe antibiotic eye drops and anti-inflammatory medications if inflammation is detected. Eye drops can effectively treat the condition in most cases of simple inflammation.
Surgery May Be Necessary
When the tear ducts are narrowed or blocked, surgery may be required. There are two primary options: silicone tube insertion and dacryocystorhinostomy (DCR). A silicone tube is inserted into the tear duct for 3-6 months, allowing tears to flow through the tube along the duct walls. This procedure generally has a good prognosis. Dacryocystorhinostomy (DCR) creates a new tear drainage pathway when the existing duct is blocked. DCR is performed inside the nose using an endoscope, leaving no visible scars.
Wearing Glasses
Once the underlying cause is identified, epiphora can be managed and prevented from worsening with early treatment. In the meantime, wearing glasses during cold and dry weather, such as fall and winter, can help protect your eyes from harsh winds and reduce surface irritation. This simple precaution can help prevent excessive tearing and improve overall eye health.
Avoiding Irritating Environments
Above all, avoiding environments that may irritate your eyes is essential. As temperatures drop and the air becomes drier, it is recommended to maintain indoor humidity at around 60%. If you notice unexplained tearing, eye discharge, or crusting around your eyes, you must visit an ophthalmologist for a thorough examination. Additionally, keeping the area around your eyes clean and minimizing excessive computer use are key steps in preventing epiphora, especially during the colder fall and winter months.
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