Why do eyes water?
In order for the eye to remain healthy, it must remain moist. Lacrimal gland is a specialized gland located under the outer one-third of the upper eyelid that makes tears. Each time you blink, the eyelid spreads the tears over the surface of the eye and pumps excess tears into a “duct” that drains the tears into your nose. That is why your nose runs when you cry.
Excessive watering may occur due to excess tear production or due to obstruction in the draining channels. The latter is more common. Less commonly, the blinking or ‘pumping’ action of the lids may be faulty. Typically the symptom of watering tends to be worse outdoor and often gets aggravated by cold and windy weather.
What can happen then?
If the tear duct gets blocked and results in swelling of the tear sac by the side of the nasal bridge, the stagnant tear may get infected giving rise to a painful abscess forming condition called ‘dacryocystitis’.
Sometimes the blockage may be closer to the eye lids. If the tearing causes severe symptoms, surgery can be performed to create a new tear duct. This operation is called “dacryocystorhinostomy.” ( DCR ). This operation is commonly done under general anaesthesia with you being put to sleep.
The DCR operation may be done via the nose using special equipments or through the skin by the side of the nose. The latter is more traditional but can give rise to a scar which is usually small. Approach via the nose is often suitable for only certain patients and your doctor will be able to advise you on that.
Your doctor may place small silicone tubes temporarily to keep the new tear duct open while healing occurs. Surgical elimination of the obstruction by creating a new tear duct is necessary to eliminate the tearing and infection that can result from such a blockage.
Can this condition affect children?
Children are frequently born with an obstruction within the “tear duct.” When this occurs, tearing results. The stagnant tears within the “tear duct” often become infected causing pus (heavy matter) to collect between the eyelids. Such obstructions usually resolve on their own within the first few months of life. If not, the oculoplastic surgeon can eliminate this problem with surgical techniques which may vary from simple ‘no cutting or stitching’ procedure to temporarily placing silicon tubes or even DCR surgery as carried out in the adults.
Occasionally, the “tear duct” obstruction will be beyond repair. When this happens, it is necessary to surgically implant an artificial “tear duct” behind the inner corner of the eyelids to drain the tears into the nose. The artificial “tear duct” is made of Pyrex glass and is called a “Lester Jones tube.”