Trip Answers

Question answered:22/01/07 Warning! this question is over two years old.

We searched the NLH Specialist Library for Eyes and Vision, TRIP and Medline databases and located the following general information on possible causes of watering eye. The online encyclopaedia, GPNotebook states:

 

“A persistent watering eye is uncomfortable, socially embarrassing and may obscure vision. Secondary infection may develop.
Two major mechanisms may be responsible:
• lacrimation
• epiphora.” [1]

 

The entry on lacrimination in GPNotebook reads:

 

“Lacrimination
This is the overproduction of tears, principally caused by emotional or reflex stimulation of the lacrimal gland. Chronic lacrimation may deplete the lacrimal gland to such an extent that tear formation appears normal or reduced.

 

Major causes:
• corneal foreign body, abrasion or inflammation
• entropion

 

Less frequently:
• crocodile tears
• psychic stimulation - crying
• cholinergic or anticholinesterase drugs
• dacryoadenitis
• lacrimal gland tumours.” [2]

 

Concerning epiphora, GPNotebook states:

 

“This describes excessive tearing due to defective drainage of tears through the lacrimal passages.
Major causes include:
• facial palsy - orbicularis oculi muscle weakness which impairs the pumping action of the canaliculi
• punctal malposition - ectropion
• punctal occlusion - congenital absence, scarred, blockage e.g. due to chronic infection with staphylococcus or herpes simplex, or following chronic drug administration
• canalicular obstruction secondary to canaliculitis
• nasolacrimal duct obstruction

 

The patency of the lacrimal system should be explored to assess the precise cause of the epiphora. Careful inspection will reveal an ectropion or punctal occlusion. Probing and syringing of the lacrimal passages will reveal obstruction in the canaliculus or the nasolacrimal duct; the site may be precisely delineated by contrast radiography - dacryocystography. In infants, the patency of the nasolacrimal duct may be explored by syringing.” [3]

 

In addition, we found two patient information leaflets discussing possible causes and management of watering eye which may be viewed by following the links in the references section. [4 & 5]

 

References
1. http://www.gpnotebook.co.uk/simplepage.cfm?ID=288686096
2. http://www.gpnotebook.co.uk/simplepage.cfm?ID=678101018&linkID=14429&cook=yes
3. http://www.gpnotebook.co.uk/simplepage.cfm?ID=-1529872360&linkID=20480&cook=yes
4. NHS Direct. Watering eyes. December 2005. (http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=393&sectionId=5003).
5. PRODIGY. Watering eyes. Last updated June 2006. (http://www.prodigy.nhs.uk/patient_information/pils/watering_eyes.htm).

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