Abnormal Excessive Tearing (Epiphora)

Symptoms

Common signs and symptoms of Abnormal Excessive Tearing (Epiphora) include:

Constant or frequent tears running down the cheeks

Blurred vision from excess moisture in the eyes

Feeling of fullness or pressure around the eyes

Sticky or crusty discharge in the corners of the eyes

Redness and irritation of the eyelids or skin around the eyes

Difficulty seeing clearly, especially when reading

Frequent need to wipe or dab the eyes

Skin irritation or rash on the cheeks from constant moisture

Eye discomfort or burning sensation

Swelling around the tear ducts near the nose

Recurrent eye infections or styes

Sensitivity to light or wind

When to see a doctor

If you experience severe or worsening symptoms, seek immediate medical attention. Always consult with a healthcare professional for proper diagnosis and treatment.

Causes & Risk Factors

Several factors can contribute to Abnormal Excessive Tearing (Epiphora).

Epiphora develops through two main mechanisms: overproduction of tears or inadequate drainage of normal tear production.

Epiphora develops through two main mechanisms: overproduction of tears or inadequate drainage of normal tear production. The tear drainage system works like a sophisticated plumbing network, with tears flowing from the eyes through tiny openings called puncta into channels that empty into the nose. When any part of this system becomes blocked or damaged, tears back up and overflow onto the face.

Blockages can occur at multiple points in the drainage pathway.

Blockages can occur at multiple points in the drainage pathway. The most common site is the nasolacrimal duct, the final channel that carries tears into the nose. This duct can become narrowed or completely blocked due to aging, previous infections, injuries, or certain medications. Sometimes the tiny puncta at the inner corners of the eyelids become too small or close completely, preventing tears from entering the drainage system in the first place.

Overproduction of tears typically results from chronic irritation or inflammation of the eye surface.

Overproduction of tears typically results from chronic irritation or inflammation of the eye surface. Conditions like dry eye syndrome paradoxically cause excessive tearing because the poor-quality baseline tears trigger reflex tearing as the eye tries to compensate. Allergies, infections, foreign bodies, ingrown eyelashes, or eyelid problems can also stimulate the tear glands to produce far more moisture than the drainage system can handle, leading to constant overflow.

Risk Factors

Age over 60 years
Female gender, especially after menopause
History of eye infections or conjunctivitis
Previous eye surgery or facial trauma
Chronic allergies or hay fever
Dry eye syndrome or poor tear quality
Certain medications including chemotherapy drugs
Autoimmune conditions like rheumatoid arthritis
Radiation therapy to the head or neck area
Congenital abnormalities of the tear drainage system

Diagnosis

How healthcare professionals diagnose Abnormal Excessive Tearing (Epiphora):

1
Diagnosing epiphora begins with a thorough eye examination and detailed discussion about when the tearing occurs, what makes it better or worse, and any associated symptoms.
Diagnosing epiphora begins with a thorough eye examination and detailed discussion about when the tearing occurs, what makes it better or worse, and any associated symptoms. Your eye doctor will examine the eyelids, tear ducts, and eye surface using specialized instruments and bright lights to look for signs of inflammation, blockage, or structural problems.
2
Several specific tests help pinpoint the exact cause of excessive tearing.
Several specific tests help pinpoint the exact cause of excessive tearing. The dye disappearance test involves placing a small drop of fluorescent dye in the eye and observing how quickly it drains away. Normal drainage clears the dye within a few minutes, while blocked ducts cause the dye to persist much longer. Tear duct irrigation involves gently flushing sterile saline through the drainage system to identify the location and severity of any blockages.
3
More advanced imaging may be necessary in complex cases.
More advanced imaging may be necessary in complex cases. Dacryocystography uses contrast dye and X-rays or CT scans to create detailed pictures of the entire tear drainage pathway, revealing exactly where blockages occur and helping plan appropriate treatment. Your doctor will also test for underlying conditions like dry eye syndrome, allergies, or infections that might be contributing to the problem.

Complications

The most immediate complications of untreated epiphora involve skin irritation and infection from constant moisture exposure.
The delicate skin around the eyes can become red, raw, and painful from frequent wiping and constant wetness.
This creates an environment where bacteria and fungi can thrive, potentially leading to secondary skin infections that require additional treatment.
More serious complications can develop when tear stagnation occurs in blocked drainage systems.
Dacryocystitis, an infection of the tear sac, causes significant pain, swelling, and redness near the inner corner of the eye.
This condition may require antibiotic treatment and can occasionally progress to more serious infections if not addressed promptly.
Rarely, chronic infections can spread to surrounding tissues or even affect vision if they involve the eye itself.

Prevention

Preventing epiphora focuses primarily on maintaining good eye health and avoiding conditions that can damage the tear drainage system.
Regular eye examinations help detect early signs of problems before they become severe, allowing for prompt treatment of infections, allergies, or other issues that could lead to drainage system damage.
Protecting your eyes from injury and infection reduces the risk of developing blockages later in life.
This includes proper hygiene when handling contact lenses, avoiding rubbing or touching the eyes with dirty hands, and seeking prompt medical attention for eye infections or injuries.
People with chronic allergies should work with their doctors to keep symptoms well-controlled, as repeated inflammation can eventually scar the delicate drainage channels.
While age-related changes to the tear drainage system can't be completely prevented, maintaining overall good health may help preserve normal function longer.
This includes staying well-hydrated, managing underlying health conditions like autoimmune diseases, and being aware that certain medications can affect tear production or drainage.
If you notice persistent tearing, addressing it early often leads to better outcomes than waiting until the problem becomes severe.

Treatment Approaches

Treatment for epiphora depends entirely on the underlying cause, with options ranging from simple conservative measures to sophisticated surgical procedures.

Treatment for epiphora depends entirely on the underlying cause, with options ranging from simple conservative measures to sophisticated surgical procedures. For cases caused by irritation or inflammation, the first approach typically involves addressing the source of irritation through artificial tears, anti-allergy medications, or antibiotics for infections. Warm compresses applied several times daily can help open blocked oil glands and improve overall eye comfort.

SurgicalMedicationAntibiotic

When tear duct blockages are the culprit, several procedures can restore normal drainage.

When tear duct blockages are the culprit, several procedures can restore normal drainage. Punctal dilation involves gently stretching the tiny drain openings to allow better tear flow. For more significant blockages, dacryocystorhinostomy creates a new drainage pathway directly from the tear sac into the nose, bypassing the blocked natural route. This procedure can often be performed endoscopically through the nose, avoiding external incisions.

Surgical

Silicone tubes or stents may be temporarily placed in the tear ducts to keep them open during healing after procedures.

Silicone tubes or stents may be temporarily placed in the tear ducts to keep them open during healing after procedures. These tiny devices are usually well-tolerated and removed after several months once the new drainage pathway is established. In cases where the eyelids don't close properly or are positioned abnormally, eyelid surgery may be necessary to restore normal tear distribution and drainage.

Surgical

Botulinum toxin injections represent an emerging treatment option for cases involving tear gland overproduction.

Botulinum toxin injections represent an emerging treatment option for cases involving tear gland overproduction. Small amounts injected into the tear gland can reduce excessive tear production for several months, providing relief for people who aren't candidates for drainage procedures or who have refractory symptoms despite adequate drainage.

Living With Abnormal Excessive Tearing (Epiphora)

Managing daily life with epiphora often requires practical adaptations and emotional resilience. Keep soft, absorbent tissues readily available in all your frequented locations - your car, office, purse, and bedside table. Many people find that gently blotting rather than wiping reduces skin irritation, and using a barrier cream around the eyes can protect against constant moisture. Consider wearing wraparound sunglasses outdoors to reduce wind and light sensitivity that can worsen tearing.

Work closely with your healthcare team to optimize your treatment plan.Work closely with your healthcare team to optimize your treatment plan. Keep a symptom diary noting when tearing is worse or better, as this information helps doctors fine-tune your care. Don't hesitate to seek emotional support if the condition affects your confidence or social interactions - many people feel self-conscious about constant tearing, but effective treatments are available.

Practical workplace accommodations might include positioning your computer screen to minimize glare, using artificial tears regularly, and taking brief breaks to manage symptoms during long tasks requiring visual concentration.Practical workplace accommodations might include positioning your computer screen to minimize glare, using artificial tears regularly, and taking brief breaks to manage symptoms during long tasks requiring visual concentration. Most people with properly treated epiphora can maintain their normal activities and quality of life. Connect with others who understand the condition through support groups or online communities, where you can share practical tips and emotional support.

Latest Medical Developments

Latest medical developments are being researched.

Frequently Asked Questions

Will my excessive tearing go away on its own?

Mild, temporary tearing often resolves when underlying causes like allergies or infections are treated. However, structural problems with tear drainage typically require medical intervention and rarely improve without treatment.

Can I still wear contact lenses if I have epiphora?

This depends on the underlying cause of your tearing. Your eye doctor can evaluate whether contact lens wear is appropriate for your specific situation and may recommend particular types or care routines.

How successful is surgery for blocked tear ducts?

Dacryocystorhinostomy surgery has success rates of 85-95% for restoring normal tear drainage. Most people experience significant improvement in their symptoms after the procedure and healing period.

Is excessive tearing ever a sign of something serious?

While epiphora itself is usually not dangerous, it can occasionally indicate underlying conditions that need treatment. Any sudden onset of severe tearing with pain or vision changes should be evaluated promptly.

Can medications cause excessive tearing?

Yes, certain medications including some chemotherapy drugs, glaucoma medications, and even some over-the-counter eye drops can affect tear production or drainage. Discuss all medications with your doctor.

How long does recovery take after tear duct surgery?

Most people can return to normal activities within a few days to a week. Complete healing and optimal results typically develop over 2-3 months as swelling resolves and new drainage pathways mature.

Will insurance cover treatment for epiphora?

Most insurance plans cover medically necessary treatments for epiphora, especially when the condition significantly impacts vision or daily functioning. Check with your provider about specific coverage details.

Can children develop excessive tearing?

Yes, children can have epiphora, often due to congenital blockages of the tear drainage system. Many cases in infants resolve naturally, but persistent problems may require treatment.

Does dry eye really cause excessive tearing?

Paradoxically, yes. Poor-quality tears in dry eye syndrome trigger reflex tearing as your body tries to compensate, leading to overflow tearing despite having underlying dryness.

What should I do if my symptoms suddenly worsen?

Contact your eye doctor promptly if you develop sudden severe tearing, pain, vision changes, or signs of infection like swelling or discharge. These could indicate complications requiring immediate attention.

Update History

May 8, 2026v1.0.0

Published by DiseaseDirectory