There are a number or tear duct issues that can occur in both adults and children, causing varying degrees of watery eyes symptoms.
Tearing is most commonly due to a blockage or narrowing of the nasolacrimal duct. The nasolacrimal duct tends to narrow with age, but this process is probably exacerbated by persistent infections and can occur earlier in life (see Tearing in Children). In order to cure tearing caused by nasolacrimal duct narrowing or obstruction a dacryocystorhinostomy (DCR) is required, less commonly placing a stent within the nasolacrimal duct can be used to treat the watery eye.
Narrowing of the tear drainage system may also be due to injury, sinus infection or a stone (calculus) within the drainage system, but often we cannot be certain of the cause of the obstruction prior reparative surgery.
As the tears are being constantly produced by the tear glands, if the tear drainage system is not working well then tears will build up and cause a watery eye or they can overflow over the eyelids onto the cheeks resulting in “epiphora”. The surface of eye (conjunctiva) produces mucus and so a complete outflow obstruction will result in mucus discharge from the eye.
If there is a narrowing or blockage of the tear outflow tract then surgery can be performed to create a functioning tear drainage system. This surgery is called a Dacryocystorhinostomy or DCR.
If there is lid malposition, then the little holes within the eyelids that accept the tears into the drainage system do no function and this will also cause a watery eye.
What are the symptoms of a blocked tear duct?
Poor tear drainage can lead to recurrent infections, either in the form of conjunctivitis, or even severe infection and abscess formation within the tear duct and sac.
More common symptoms include, blurring of vision, inability to keep glasses from fogging up and mucus discharge.
When should tear duct obstruction be treated?
If your tearing is severe enough to cause significant symptoms and interfere with quality of life it is reasonable to have surgery. Recurring conjunctivitis is a relatively strong indicator to proceed to surgery however once a patient has suffered an episode of dacryocystitis (severe infection or abscess within the tear duct) DCR surgery must be performed to avoid recurrent severe infections.