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It is important to determine the cause of watery eyes so the underlying problem can be tackled. The first step is for you to see an ophthalmic specialist who will take a full medical history and perform a physical eye examination.

How are watery eyes investigated?

Investigations for watery eyes include checking whether enough tears are being produced to keep the eye moist. The Schirmer test, also known as the tear test or dry eye test, may show that the resting tear production is abnormal.

Both eyes are tested at the same time; the eye is first numbed to prevent any irritation and then small strips of blotting paper are placed just under each lower eyelid. After 5 minutes the amount of fluid transferred to the blotting paper is measured to give an indication of resting tear volume.

Syringing the tear passages is normally done as part of the consultation with an ophthalmologist. He or she uses a cannula to pass saline through the tear canaliculi and lacrimal duct; this can reveal if the system allows clear passage of tears.

Some people find that syringing reduces symptoms of watery eye in the short-term, though the effect is usually temporary and the problem often recurs.

Treating watery eyes

Once the specific cause of watery eyes is identified, treatment is tailored to each individual. This can include:

  • Simple advice about eyelid care.
  • Prescribed drops that contain topical antibiotics, artificial tears or antihistamines.
  • Punctal plugs: these are very small plugs, no larger than a grain of rice, that are placed in the tear duct to stop tears draining away. Once in place, they increase the amount of fluid bathing the eye, which reduces dryness. They can be useful if the underlying problem is tears escaping too quickly or if punctal stenosis (blockage of the small channels in the rim of the eyelid) is the main problem. However, they often come out and may even move and block the tear duct itself, so are often not a permanent solution.
  • Punctoplasty: surgery to enlarge the tear puncta (the tiny holes through which tears first drain) is often successful when the rest of the tear drainage system is in good order. If there is blockage in the tear canaliculi or lacrimal ducts, a more extensive dacryocystorhinostomy will be required.
  • Dacryocystorhinostomy: an operation to create a new channel for tears to flow from the lacrimal sac to the nose. It is recommended when the underlying problem is an obstruction in the nasolacrimal duct. The surgeon makes a small skin incision at the side of the bridge of the nose, or through the nose itself using an endoscopy probe, and then connects the lacrimal sac into the nose. This is often successful in people with obstructive watery eye that has not responded to other treatments.

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