Excessive tearing , also known as epiphora , is a common eye symptom that can significantly affect a patient's quality of life. Although it is commonly associated with emotions or allergies, when it is persistent or occurs without an obvious cause, it may indicate an ophthalmological problem that requires specialist evaluation.
At Clínica Nivaria , we have a team of experts in the diagnosis and treatment of chronic or abnormal tearing. Below, we explain why it can occur, how it is diagnosed, and what the best available solutions are.
What is excessive tearing?
Excessive tearing occurs when there is an abnormal increase in the amount of tears in the eye or on the face , either due to overproduction or an obstruction in the tear drainage .
Under normal conditions, the eye constantly produces tears to keep the ocular surface lubricated, clean, and protected. These tears drain through a specific system that includes:
- tear duct
- Tear canaliculi
- Lacrimal sac
- Nasolacrimal duct (which connects to the nose)
When this balance is disrupted, excessive tearing occurs.
Types of tearing
1. Reflex tearing (due to overproduction)
The eye reacts to an irritant by increasing tear production. The most frequent causes are:
- Eye irritation (dust, wind, smoke)
- Infections or inflammations (conjunctivitis, blepharitis)
- Allergies
- Foreign body
- Dry eye (paradoxically, it can generate excess tears as a compensatory mechanism)
2. Tearing due to impaired drainage
Tears are produced normally, but they cannot drain efficiently into the nose, accumulating and overflowing:
- Nasolacrimal duct obstruction
- Stenosis (narrowing) of the canaliculi
- eyelid malpositions (ectropion, entropion)
- Tumors or inflammations in the tear duct
Symptoms that accompany tearing
Although the main symptom is the accumulation of tears or "constant crying", other associated discomforts may appear:
- Eye irritation
- Redness
- Blurred vision (due to constant tears on the cornea)
- Sensation of grit or a foreign body
- Repeated infections of the lacrimal sac (dacryocystitis)
- Inflammation or pain in the tear duct area
When is it necessary to see an ophthalmologist?
It is important to consult a specialist if you experience excessive tearing:
- Is it persistent or recurrent?
- It only affects one eye
- It is accompanied by mucous or purulent secretion
- It obstructs a clear view
- It is associated with pain or redness
- It has appeared after surgery or facial trauma.
- It causes aesthetic or functional discomfort
At Clínica Nivaria , we evaluate each case to determine if the problem is functional, mechanical, or inflammatory.
Most frequent causes of excessive tearing
1. Dry eye with reflex tearing
Although it may seem contradictory, dry eye can cause excessive tearing as a response to chronic irritation . These reflex tears are of poor quality and do not provide adequate hydration, so they do not solve the problem.
2. Blepharitis
Inflammation of the eyelid margin affects the stability of the tear film, leading to intermittent tearing, especially in windy or air-conditioned environments.
3. Conjunctivitis
Viral or bacterial infections can stimulate tear production as part of the inflammatory process.
4. Foreign body
An eyelash, dust particle, or debris can cause irritation and reflex tearing. The foreign body usually passes on its own, but if it persists, it should be removed by an ophthalmologist.
5. Nasolacrimal duct obstruction
Very common in older adults and babies. Tears cannot drain into the nose, so they constantly overflow. This can be accompanied by recurrent infections in the tear duct area.
6. Ectropion or entropion
When the eyelid is misaligned (turned outward or inward), normal tear drainage is disrupted, resulting in constant tearing. This requires evaluation and, in many cases, surgical correction.
7. Polyps or allergic rhinitis
Nasal abnormalities can partially obstruct the tear duct from its exit in the nose, hindering drainage.
Diagnosis of excessive tearing
The diagnosis is made through a complete ophthalmological evaluation that includes:
1. Detailed medical history
Valued:
- Onset and duration of tearing
- Whether it is bilateral or unilateral
- Accompanying symptoms
- Surgical history, trauma, or nasal diseases
2. Slit-lamp eye examination
It allows you to evaluate:
- Ocular surface
- Tear quality
- Eyelid position
- Presence of blepharitis, conjunctivitis, or dry eye
3. Specific tests
a) Fluorescein test
Dye that allows assessment of the tear film's path and whether there is an obstruction in the drainage.
b) Irrigation and probing of the lacrimal duct
Under local anesthesia, a solution is introduced to check if the tear duct is open or blocked.
c) Dacryocystography
Radiological study with contrast to visualize the anatomy of the lacrimal duct.
d) Anterior segment OCT or meibography
In cases of suspected dry eye or eyelid gland dysfunction.
Treatments available at Clínica Nivaria
The treatment for excessive tearing depends entirely on its cause. At Clínica Nivaria , we offer personalized solutions that include:
1. Tearing due to irritation (reflex)
✔️ Dry eye treatment:
- Preservative-free artificial tears
- Eyelid hygiene
- Omega-3 supplements
- Intense pulsed light (IPL)
- Autologous serum in advanced cases
✔️ Blepharitis treatment:
- Daily eyelid cleansing
- Hot compresses
- Topical antibiotics if there is an infection
2. Lacrimal duct obstruction in adults
✔️ Dacryocystorhinostomy (DCR) surgery
It is the most effective treatment for nasolacrimal duct obstruction. It consists of creating a new drainage pathway between the lacrimal sac and the nasal cavity.
At Clínica Nivaria we perform this procedure using minimally invasive techniques and with local anesthesia or sedation, allowing for a quick and safe recovery.
3. Eyelid malpositions (ectropion/entropion)
It is corrected through specific eyelid surgery, restoring the normal position of the eyelid and improving tear drainage.
4. Tearing in babies (congenital obstruction)
In most cases, it resolves spontaneously during the first year of life. If it persists:
- Specific tear duct massages are indicated.
- In some cases, tear duct probing is performed under sedation.
- Surgery is reserved for refractory cases
What happens if it's not treated?
Excessive tearing may seem like a mild symptom, but if left untreated, it can lead to:
- Irritation and damage to the skin of the eyelid
- Chronic blurred vision
- Frequent infections (dacryocystitis)
- Aesthetic and social impact
- Risk of complications if associated with eyelid malpositions or chronic infections
Therefore, a proper diagnosis and timely treatment are essential.
Why choose Clínica Nivaria?
At Clínica Nivaria , we offer comprehensive care for patients with excessive tearing, including:
- Ophthalmologists specializing in lacrimal system, ocular surface and oculoplastic surgery.
- Accurate diagnosis with specific tests and cutting-edge technology.
- Personalized and minimally invasive surgeries.
- Specialized pediatric care for congenital lacrimal obstruction.
- Personalized service, continuous follow-up, and clear guidance at every step.
Excessive tearing can have a variety of causes, from minor eye irritations to blockages in the tear ducts that require surgery. Therefore, it's important not to dismiss this symptom as normal and to see an ophthalmologist for a complete evaluation.
At Clínica Nivaria , we are prepared to help you find the cause of your tearing and offer you the most effective solution, tailored to your needs.
Do you have constant watery eyes? Consult with our specialists
📍 We look forward to seeing you in Santa Cruz de Tenerife.
🌐 Book your appointment online.
🕒 Specialized care in diagnosis and treatment of the lacrimal duct.
Nivaria Clinic: Your vision, our priority.
