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What Causes Excessive Tearing?

Excess tearing can be a perpetual nuisance. The condition occurs when the amount of tears produced by the eye overwhelms the tear drainage mechanism. Even though tearing by itself never harms the eye, it can blur vision and produce discomfort in social situations. Our eye doctors in Hamilton, N.J. understand the problems caused by excessive tearing and can treat its causes.

The tear film — a complex solution made up of mucous, salt water and oil — is essential for the health of the eye. There must be a balance between the tears produced and the tears drained. That balance is achieved when tears leave the eye. This occurs in 1 of 3 ways:

  • Evaporation
  • Down the tear ducts
  • Flowing out onto the cheek

Does dry eye cause tearing?

In most cases, no. A better definition of tearing is needed to answer this question. When tears leave the confines of the eyelids and run down the cheek, that’s called tearing.  This is almost never caused by dry eyes. Dry eye patients feel their eyes are wet and may call it tearing but the tears do not run down the cheek. Instead, patients with dry eye have excess mucous and oil in the tear film and this causes a slime that makes the eyes feel wet. Incorrectly treating the condition can make tearing worse.

Nearly all excessive tearing patients have a structural abnormality of the tear drainage system. This illustration shows the tear drainage system’s anatomy. There is a small tear duct in both the upper and lower eyelids called the canaliculus. These come together and drain to the lacrimal sac. The lacrimal sac joins with the nasolacrimal duct that travels through a bony canal to exit in the nose. 

Incorrectly positioned eyelids block the small tear ducts from contacting the tear lake, preventing tears from draining. Excess conjunctiva (the clear film that covers the white of the eye) may cover the opening to the tear duct. The nasolacrimal duct may be narrow or blocked as it travels down the bony canal into the nose. Blockage of the nasolacrimal duct not only causes tearing but also an accumulation of discharge in the eye and puts one at risk for a serious infection known as dacryocystitis.

These structural abnormalities often require surgery to alleviate the blockage and restore normal tear outflow.  Fortunately, many of these procedures are relatively minor and can be performed in the office.  Some do require outpatient surgery.

Tearing can be extremely bothersome and interfere with clarity of vision and your ability to perform at your best. Fortunately, our ophthalmology practice serving Princeton, Hamilton Township, and Monroe Township have the tools and the expertise to diagnose and treat all causes of tearing. We recommend coming in for a consultation if you’re bothered by excessive tearing.

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