Excessive Lacrimation: Causes & Treatment

Excessive Lacrimation: Causes, Symptoms, Diagnosis, and Treatment

Excessive lacrimation, commonly referred to as watery eyes or epiphora, is a condition characterized by an abnormal increase in tear production. This condition can be both distressing and disruptive, affecting an individual’s quality of life. Understanding the underlying causes, recognizing the symptoms, accurately diagnosing the condition, and exploring appropriate treatments are crucial steps in managing excessive lacrimation effectively.

Causes of Excessive Lacrimation

The causes of excessive lacrimation are diverse and can be classified into several categories:

Environmental Irritants: Exposure to irritants such as smoke, dust, wind, or strong odors can lead to increased tear production as the eyes attempt to flush out these foreign particles.
Allergies: Allergic reactions, whether to pollen, pet dander, or certain foods, can trigger excessive tear production. Allergic conjunctivitis, in particular, is a common condition where the conjunctiva becomes inflamed due to allergens, leading to watery eyes.
Infections: Eye infections, including bacterial or viral conjunctivitis, can cause excessive lacrimation. Infections lead to inflammation and irritation of the conjunctiva, prompting the eyes to produce more tears as a defense mechanism.
Dry Eye Syndrome: Paradoxically, dry eye syndrome can lead to excessive lacrimation. When the eyes do not receive adequate lubrication, the body may overcompensate by producing more tears, which can sometimes result in a watery appearance.
Blocked Tear Ducts: Tear ducts, or puncta, can become blocked or narrowed due to various reasons, including infections or anatomical abnormalities. When tears cannot drain properly, they accumulate and lead to excessive watering of the eyes.
Eyelid Problems: Conditions affecting the eyelids, such as blepharitis (inflammation of the eyelid margins) or entropion (inward turning of the eyelid), can result in improper tear distribution and increased lacrimation.
Systemic Diseases: Certain systemic diseases, such as autoimmune conditions like Sjögren’s syndrome, can impact tear production and lead to excessive watering of the eyes.
Medications: Some medications, particularly those with anticholinergic properties, can affect tear production and contribute to lacrimation.

Symptoms of Excessive Lacrimation

The primary symptom of excessive lacrimation is an abnormal increase in the volume of tears. However, this condition often presents with additional symptoms that may vary depending on the underlying cause:

Constantly Watery Eyes: The eyes may appear perpetually moist or teary, even without apparent external triggers.
Redness and Irritation: The eyes may become red and irritated due to prolonged exposure to tears or underlying inflammation.
Blurred Vision: Excessive tears can blur vision temporarily, affecting daily activities and tasks.
Discomfort: Individuals may experience discomfort or a feeling of grittiness in the eyes due to tear overflow or associated conditions.
Crusting and Discharge: In cases of infection or conjunctivitis, there may be associated discharge or crusting around the eyes.

Diagnosis of Excessive Lacrimation

Accurate diagnosis of excessive lacrimation requires a comprehensive evaluation by an eye care professional. The diagnostic process typically includes:

Medical History: The ophthalmologist or optometrist will gather detailed information about the patient’s medical history, including any existing health conditions, medications, allergies, and previous eye issues.
Physical Examination: A thorough eye examination is conducted to assess the overall health of the eyes. This includes inspecting the eyelids, conjunctiva, cornea, and tear ducts.
Tear Production Tests: Tests such as the Schirmer test or tear break-up time (BUT) can measure tear production and tear film stability, providing insights into potential causes of excessive lacrimation.
Fluorescein Dye Test: This test involves applying a fluorescent dye to the surface of the eye to evaluate tear drainage through the tear ducts and identify any blockages or abnormalities.
Imaging Studies: In some cases, imaging studies such as dacryocystography or orbital ultrasound may be used to visualize the tear ducts and surrounding structures, especially if a blockage or anatomical issue is suspected.

Treatment of Excessive Lacrimation

Treatment of excessive lacrimation is tailored to address the underlying cause of the condition. Common treatment approaches include:

Environmental and Lifestyle Adjustments: Reducing exposure to environmental irritants, such as smoke or allergens, can help alleviate symptoms. Using protective eyewear or humidifiers may also be beneficial.
Allergy Management: For individuals with allergic conjunctivitis, antihistamines or anti-allergy eye drops can help control symptoms and reduce excessive tear production.
Infection Treatment: If an eye infection is diagnosed, appropriate antimicrobial treatments, such as antibiotic or antiviral eye drops, may be prescribed to address the infection and alleviate symptoms.
Dry Eye Management: For dry eye syndrome, artificial tears or lubricating eye drops can provide relief by improving tear film stability and reducing compensatory tear production.
Tear Duct Procedures: If a tear duct blockage is identified, procedures such as dilation, irrigation, or even surgical interventions may be necessary to restore normal tear drainage.
Eyelid Surgery: In cases of eyelid abnormalities like entropion or ectropion (outward turning of the eyelid), surgical correction may be recommended to improve eyelid function and tear distribution.
Systemic Treatment: For systemic conditions affecting tear production, managing the underlying disease with appropriate medications or therapies can help control excessive lacrimation.
Medication Review: If medication-induced lacrimation is suspected, consulting with a healthcare provider to review and potentially adjust the prescribed medications may be necessary.

Conclusion

Excessive lacrimation can significantly impact an individual’s daily life and comfort. Identifying the underlying cause through a thorough diagnostic process is essential for effective management. By addressing environmental factors, treating infections or allergies, and considering appropriate interventions for structural or systemic issues, individuals can find relief from excessive tear production and improve their quality of life. Regular consultation with an eye care professional ensures that any changes in symptoms are monitored and managed effectively.