Watery Eyes & Tear Duct
(Lacrimal) Disorders

Constantly watery eyes (epiphora) can blur vision, irritate the skin, and be a daily nuisance. Tearing has two basic causes: the eye making too many tears, or tears not draining properly. At Belaray Dermatology, watery-eye and tear-drainage problems are evaluated and treated by Dr. Rachel Ellis, a board-certified ophthalmologist and fellowship-trained oculofacial plastic and reconstructive surgeon who specializes in the eyelids and the lacrimal (tear-drainage) system.

How Tears Normally Drain

Tears wash across the eye and drain through tiny openings (puncta) at the inner corner of the eyelids, into small canals, then into the tear sac and down the nasolacrimal duct into the nose. A problem anywhere along this path — or an eyelid that does not sit properly against the eye — can cause overflow tearing.

Common Causes of Watery Eyes

• Blocked tear duct (nasolacrimal duct obstruction): The drainage duct narrows or blocks, so tears back up and overflow. It can also cause recurrent tearing with mucus or infection of the tear sac (dacryocystitis).
• Punctal problems: The drainage openings can become too narrow, closed, or malpositioned.
• Eyelid malposition: Ectropion (an out-turned lid) pulls the drainage opening away from the eye; laxity keeps tears from being pumped away.
• Dry eye / surface irritation: A dry or irritated surface triggers reflex overproduction of tears.
• Eyelash or eyelid conditions: Inflammation (blepharitis), styes, or inturned lashes.

How It Is Evaluated

Evaluation includes examining the eyelids, lashes, tear-drainage openings, and eye surface, and testing whether the drainage system is open — often by gently irrigating the tear duct. This distinguishes overproduction from a drainage blockage and pinpoints where along the pathway the problem lies.

Treatment Options

Treatment is matched to the cause:

• Treat the surface or eyelid cause: Managing dry eye, blepharitis, or repairing an eyelid that no longer sits against the eye often resolves the tearing.
• Punctal or duct procedures: Opening a narrowed drainage opening, or probing and, when appropriate, placing a temporary stent.
• Dacryocystorhinostomy (DCR): For a blocked tear duct, this procedure creates a new drainage pathway from the tear sac into the nose, bypassing the blockage.

When to See a Specialist

See a specialist for tearing that persists, blurs vision, or irritates the skin; for recurrent tear-sac infection, mucus discharge, or swelling at the inner corner of the eye; or when watering follows an eyelid change. Learn more about related eyelid conditions: ectropion & entropion and eyelid surgery.

Frequently Asked Questions

Why do my eyes water constantly?

Constant watering (epiphora) has two basic causes: the eye producing too many tears, or tears not draining properly. Common culprits include a blocked tear duct, narrowed drainage openings, an eyelid that no longer sits against the eye, and — surprisingly — dry eye, which triggers reflex tearing. An exam identifies which is responsible.

What is a blocked tear duct?

A blocked tear duct (nasolacrimal duct obstruction) is a narrowing or blockage of the channel that drains tears from the eye into the nose. Tears back up and overflow onto the cheek, and the tear sac can become infected, causing tenderness, swelling, or mucus at the inner corner of the eye.

How is a blocked tear duct fixed?

When conservative measures are not enough, a blocked tear duct is treated by opening or bypassing the blockage. In adults this is often a dacryocystorhinostomy (DCR), which creates a new drainage pathway from the tear sac into the nose. Narrowed drainage openings can sometimes be opened or stented.

Can an eyelid problem cause watery eyes?

Yes. If the lower eyelid turns outward (ectropion) or becomes lax, the tear-drainage opening is pulled away from the eye and tears are no longer pumped away efficiently, causing overflow. Correcting the eyelid position often resolves the tearing.