All welled up?

Eyes can pose so many different issues for people, but I recently had a question posed to me about watery eyes.  Like super watery, all the time, so that it ruins eye makeup, and looks like your eyes are constantly watering.  Besides being a total sap and crying 24/7 and merely pretending it is a medical condition, I am here to tell you, it actually IS!

What's the deal?
Epiphora is a condition where there is an overflow of tears onto the face, and it is usually due to the inability to drain the tears through the nasolacrimal system. Basically the inner corner of your eyes, can drain fluids from your eyes into your nasal canal to help get rid of the fluids, whisk them away (if you will), and when that system is blocked, or just overrun (like a sewer drain in heavy rainfall) the fluids go down your cheeks- like when you cry.  Just as an FYI, this flow of fluids into the nasal canal is one reason why everyone gets a runny nose when they cry- it is impossible not to....well, I guess unless you have this condition and the ducts are blocked!

Why does this happen?
So these blockages usually occur due to age (occurs gradually), infections, irritation or allergic reactions. And in babies it can be due to the inability of the duct from opening (just plain bad luck), or in the case of someone who has had any facial trauma (broken nose, facial bones around the eyes) the tissue poorly healed after the trauma and allowed for the ducts not to open properly.  When you go to see your HCP, if you have this problem with weepy eyes, they can add some dye to your eyes, and essentially watch to see where the tears go (with imaging- like a CT scan): into your nose or just bubble right over your eyelids onto your cheeks?  If they don't go into the nasolacrimal system, you have your answer: a blocked duct it is!  And some people just have an overproduction of tears from irritants such as fumes/chemicals/eye makeup OR an allergic reaction.  The best way to figure this one out is to notice when the overproduction of tears occur, i.e. is it always after putting on make-up?  After petting your cat? When you are exposed to certain fumes or chemicals?  If so, you need to see an allergist!

How do I treat it?
So, if it is merely an infection or allergic reaction, you treat the bacteria with antibiotics, and for an allergic reaction you can either take antihistamines OR stay away from the irritant (i.e. stay away from chemicals that cause the reaction or change brands of eye makeup).  If the ducts are blocked, or in the case of aging, you can have surgery to fix the issue. So there are two types of surgery depending on the issue: sometimes with aging the eyelid just gets saggy and turns outwards (ectropion) and the surgery merely tightens up the eyelid to stop the dropping and ends the weeping.  If the duct is completely blocked, you might need surgery called a dacryocystorhinostomy (that's a mouthful, right??) basically where they recreate the nasolacrimal duct that drains into the nasal passage, and it bypasses the area that was blocked.  If the ducts are not fully blocked but just small, they can be widened, under anesthesia, to allow for proper flow of tears from your eyes.

The bummer is that there is no magic pill to fix this problem, but the good news is that there are ways of trying to figure out the issue on your own, like changing eye makeup, taking antihistamines, and trying to figure out if it is an allergic reaction or irritation versus a real life blocked duct.  If it is just one eye, then you might have a blocked duct and you should go to your HCP to see what is going on with those weepy eyes!  But there is no need to look like a little dog with weepy, wet eyes all the time, so go see your HCP and get to the bottom of those wet cheeks and make excuses no more!

Yours in Good Health
B