Watery eyes

Dr. rer. nat. Daniela Oesterle is a molecular biologist, human geneticist and trained medical editor. As a freelance journalist, she writes texts on health topics for experts and laypeople and edits specialist scientific articles by doctors in German and English. She is responsible for the publication of certified advanced training courses for medical professionals for a renowned publishing house.

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Watery eyes (also: tears, epiphora) can - besides sadness and joy - have many causes. Often it is age-related disorders of the tear system, allergies and, paradoxically, too dry eyes that cause the tear water to flow excessively. Read more about what causes watery eyes and what you can do about it here.

Brief overview

• Causes: e.g. age-related changes, foreign bodies in the eye, allergies and other underlying diseases such as diabetes
• Watery eyes - what to do? Depending on the cause, provide for a "good" eye climate (e.g. ventilate rooms regularly, avoid drafts), drink enough, take breaks from computer work, have underlying illnesses treated professionally
• What remedies help with watery eyes? Depending on the cause z. B. "Artificial tears", allergy drugs, specific drugs to treat underlying diseases

Watery eyes: causes and possible diseases

In itself, a tear film is an important protective shield for sensitive eyes. It supplies the eye with oxygen, is a "lubricant" for the blink of an eye, lets the air flow by smoothly, enables sharp vision and protects against mechanical foreign bodies and infections. However, the eyes should not water excessively. If they do, the balance between tear production and removal is disturbed.

This can have numerous triggers. The most common causes of watery eyes are age-related changes, allergies and - paradoxically - eyes that are too dry. In addition, foreign bodies (e.g. inward-facing eyelashes) can irritate the eyes and cause them to water, as can an outward-facing eyelid (ectropion). Infections of the eyes, chronic infections of the bags under the eyes, and other diseases such as diabetes mellitus can also cause watery eyes. They are among the serious causes that should definitely be clarified by a doctor.

Basically, three main mechanisms can be distinguished in the development of watery eyes:

• functional disorder of the tear drainage (e.g. disorders in the function of the eyelid)
• anatomical changes in the tear ducts (e.g. obstruction of the tear ducts)
• Overproduction of tear fluid (e.g. irritation of the eyelids, conjunctiva, cornea)

Age-related causes of watery eyes

Most of the people who see an ophthalmologist about watery eyes are the elderly - especially women. Age-related changes in hormones during menopause, but also gender-independent signs of aging, can lead to functional impairment of tear drainage.

Complex muscles and surrounding connective tissue ensure the stability and function of the eyelid, the lacrimal gland and the tear pump. If the muscles and connective tissue become weaker due to hormonal changes or age-related reasons, the volume of tears can no longer be properly regulated. Watery eyes are the direct result of a malfunctioning tear pump or blocked tear ducts.

Typical symptoms and thus the cause of watery eyes are:

• a disturbed eyelid function

• Changes in the lacrimal gland
• Changes in the tear pump
• blocked tear ducts

The dry eye

In order to be able to see perfectly, the eyes must be sufficiently and evenly moistened with tear fluid. This fluid film is renewed with every blink of the eye and regulated by the tear system - lacrimal glands and tear ducts. The tear glands form the tear fluid, the blink of an eye distributes it evenly over the cornea. Then, with the help of the tear pumps, the fluid moves through the tear ducts of the upper and lower eyelids into the tear sack, from where it reaches the nasal cavity via the tear and nasal duct.

Indirectly, a slack blinking of the eye and poorly functioning tear glands lead to less tear fluid and thus initially to dry eyes. Since the tear film serves as a natural lubricant for the blink of an eye, the lids irritate the dry cornea of ​​the eye with every blink. In addition, the eyes are more susceptible to infection because the healthy tear film with its germicidal substances is missing. Even small particles stick more easily and irritate the eyes even more. The tear glands then produce so-called reflex tears - watery eyes are the result.

Causes of dry eyes

The following is an overview of the causes of dry eyes and subsequent watery eyes:

• Age-related and / or hormone-related decrease in tear fluid
• Environmental factors (ozone, exhaust gases, heating air, dry room air)
• Allergies
• contact lenses
• Medicines (e.g. cytostatics, beta blockers, antihistamines, birth control pills)
• internal diseases such as diabetes mellitus, thyroid disease, inflammatory rheumatism
• Stroke or other paralysis of the facial nerves that make it difficult to blink properly

Symptoms of dry eyes

Common symptoms of dry eyes are:

• Foreign body sensation in the eye, burning sensation, scratching
• Feeling of pressure in the eyes
• pains
• Eyelid swelling
• Secretion of mucus, sticky eyelids
• Conjunctival redness
• Visual impairment
• Glare, photophobia
• watery eyes

Watery eyes: you can do that yourself

In any case, you should have watery eyes examined medically in order to rule out serious underlying diseases and prevent possible secondary diseases. If the ophthalmologist determines that environmental factors are the cause of dry eyes and thus watery eyes, you can often relieve the symptoms yourself with these simple tips:

• Ventilate your rooms regularly and make sure that the room climate is not too dry (possibly set up a humidifier).
• Exercise in the fresh air often.
• Avoid drafts, car blowers, air conditioners.
• Refrain from smoking or avoid smoky rooms.
• Drink enough alcohol-free and caffeine-free liquids (water, mineral water, tea).
• When working for a long time, pay attention to frequent blinking in order to distribute tear fluid again and again on the surface of the eyeball. Also take more breaks from work. The use of "artificial tears" may also make sense.
• Get enough sleep - tired eyes are often irritated, itchy or burning.
• Clean the edges of your eyelids, especially when removing makeup.
• As a contact lens wearer, you should take longer breaks and ensure that the lenses are cleaned thoroughly and regularly. If necessary, talk to your doctor about a different lens shape (hard, soft lenses) to avoid watery eyes as a result of irritation.

Watery eyes: what does the doctor do?

The ophthalmologist will talk to you about your medical history (anamnesis). To do this, he asks you, among other things, about the type and duration of your complaints and any accompanying illnesses. This often provides important information about the possible causes of watery eyes.

The anatomy of your facial skull, the tear glands and bags under the eyes, as well as the texture, position and mobility of the eyelids provide further clues. Functional and diagnostic tests, such as secretion tests (to measure the amount of tear fluid), are also often useful. Further examinations may be necessary, for example if the doctor suspects a general illness such as diabetes behind the watery eyes.

Medical treatment

Treatment by the doctor depends on the cause of the watery eyes. For example, infections of the eye can be treated with medication and eyelid misalignments surgically. The doctor can correct malfunctions of the lacrimal system using certain ophthalmological methods. The doctor may prescribe eye drops ("artificial tears") if the eyes are dry or the surface of the eye is irritated.

Watery eyes: which means help?

Which remedies can help with watery eyes depends on the cause. If the tears flow due to an allergy, appropriate antihistamines can help (be careful: they can also trigger tears!). If the reason you are tearing is that you stare at the computer screen for hours, eye drops can be helpful. Watery eyes as a side effect of diabetes mellitus can disappear if the doctor correctly adjusts the patient to blood sugar-lowering medication (oral antidiabetic drugs, insulin). In menopausal women, hormone replacement therapy may reduce the hormonal imbalance and thus alleviate its side effects (such as watery eyes). However, the benefits and risks of such hormone therapy must be carefully weighed against each other!

Watery eyes: when do you need to see a doctor?

If you suffer from watery eyes, a visit to an ophthalmologist is highly recommended. On the one hand, because watery eyes - regardless of the cause - can cause long-term damage (including eyesight). On the other hand, because behind the symptoms of watery eyes there can be serious underlying diseases that absolutely must be treated.

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