May 19, 2014
David Morrow MD Guest Sun Protection Expert on KMIR
Excessive tearing, or Epiphora, has many causes. As odd as it sounds, the most common cause is dry eye. If your eye doesn’t make enough tears, the lacrimal gland responds by secreting watery tears that don’t stick to the eye. So despite the tears spilling from your lids, the eye continues to be dry. Sometimes the cycle can be broken with topical lubricants.
Another cause of excess tearing is lacrimal duct obstruction. Normally, tears are made in the eye and drain into the nose through small holes in the nasal portion of the eyelids called the punctum. A blockage anywhere from the punctum to the bony lacrimal canal in the nose can cause the tears to back-up and run down the cheek. Surgery to correct these problems ranges from dilating the tear duct to bypassing the duct by creating a new pathway into the nose.
Lower eyelid laxity from aging or prior eyelid surgery can also cause excess tearing. If the lower eyelid sits too low relative to the eye, tears will well-up behind the lid and eventually run down the cheek. The tears will also evaporate faster because more of the eye is exposed. Severe lower eyelid laxity can lead to Ectropion, where the lid rotates outward. Once again, patients experience a cycle of dry eye, excess tearing, dry eye. Surgery to correct the condition generally involves raising and tightening the lower eyelid. Severe cases require elevating the cheek as well in order to support the lower eyelid and resist gravitational pull.