Key Information

PRICE

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TIME OF PROCEDURE

60 – 90 min

DOWNTIME

1 – 2 weeks

DISCOMFORT LEVEL

3 out of 5

AVERAGE SESSION REQUIRED

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What Is Epiphora?

Epiphora is a condition in which someone’s eyes are excessively watery. This is either due to too much tear production, or a lack of tear drainage.

The human eye has its own tear duct which produces and secretes tears that lubricate the eye and wash away dirt and foreign objects. There are also tear drainage systems that serve to move the tears away and down into the nasal passages. With most people, the ducts and drains work in harmony to balance one another out.

In people who have epiphora, however, there’s an imbalance between the tear production and the ability to drain the tears away. Sometimes, the drainage system has some sort of blockage or can be particularly narrow, so the tears cannot drain away as easily as they should. This can lead to almost constant eye watering in the worst cases and other awkward and frustrating symptoms for sufferers.

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What Are the Symptoms of Watery Eyes?

The symptoms of watery eyes may include:

Itchy and watery eyes
Blurred or obscured vision
Eyes feel sticky and hard to open
Soreness and irritation
Sensitivity to light

There can also be a social and emotional impact to epiphora, as it may feel embarrassing or awkward to have your eyes water constantly, which may lead people to mistakenly assume that you’re upset.

How Is Epiphora Diagnosed?

An eye exam is essential to diagnose epiphora. During this exam, the eyes are closely inspected, particularly the tear ducts. It’s common to add coloured drops into the eye, then follow the tear trajectory to see how long it takes them to drain away. In the average person without epiphora, the drops will vanish in minutes. But in sufferers, they’ll linger much longer. You may also have the tear ducts syringed.

Specialists may also review your medical history to see if you’re at elevated risk of epiphora and conduct various other tests. These can include eye imaging to determine the root cause of your watery eyes or even X-rays and CT scans. If they believe that the problem is linked to a blockage in the tear drains or sinuses, they might also place an endoscope into your nose to examine the area from within.

What Is the Common Cause of Watery Eyes?

“Why are my eyes watering?” is one of the most common questions specialists hear on this topic, and the truth is that there are many potential causes of watery eyes. Eyes often water when dirt, smoke, or foreign objects get into them, for example. But if you’re suffering from constant, recurring watering or tears that won’t drain away, it’s likely that one of these issues might be the cause:

Excess tears: in some cases, the tear ducts simply produce too many tears and essentially overwhelm the eye and the drainage channels. This may be linked to allergies or infections, such as conjunctivitis, as well as conditions like dry eye syndrome.
Impaired drainage: many cases of epiphora are related to blockages or problems with the drainage channels that take tears out of the eye. The channels may be obstructed or very narrow, and this is particularly common in cases of newborn watery eyes.
Eyelid problems: abnormalities like ectropion (when the eyelid droops outward) or entropion (where it turns in on itself) also increase the likelihood of having watery eyes.

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Watery Eyes Treatment Options

When it comes to how to stop eyes from watering, there are both surgical and non-surgical options available. The right treatment type for each patient will depend on the severity and nature of their epiphora, and specialists will take various factors into account to develop an epiphora treatment plan.

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Non-Surgical Treatment of Watery Eyes

In relatively mild cases of watery eyes, non-surgical, non-invasive treatments are preferred, and the first step is to simply consult with either a GP or an eye specialist to determine the nature of the condition and possible root causes. They may then prescribe a treatment like:

Medications such as antihistamines to relieve allergy symptoms, if your body’s allergy response is connected to the issue.
Hot compresses and wipes to treat underlying blepharitis
The use of eye drops or even artificial tears to treat conditions like dry eye and reduce the amount of tears your ducts produce.
Using a probe to manually dilate up the tear ducts if they’re blocked or obstructed.

Close-up portrait of a young woman with freckled skin and orange flower petals placed under her eye in a fan-like pattern.

Surgical Watery Eye Treatment

In more serious cases or situations where non-surgical methods simply aren’t effective or efficient, surgery may be the only reasonable treatment for watery eyes. Specialists will usually attempt non-surgical watery eyes treatment first, but then progress to surgery if it fails. Various surgical approaches may be employed:

Dacryocystorhinostomy (DCR): this involves forming a new drainage passage between the tear ducts and the nose, in order to bypass a duct that is blocked. This may leave a small scar on the nose, depending on how the surgery is performed.
Endoscopic DCR: a more advanced take on the DCR, this involves using an endoscope (a tube with a camera and light attached) fed into the nose in order to form a new drainage channel from within, without the risk of exterior scarring.
Lester Jones Tube: this involves inserting a glass tube that connects the corner of the eye with the nasal passages to serve as a drainage channel for tears if the existing channel is damaged, narrow, or malformed.

Note that in both versions of the DCR, a small plastic tube is typically inserted into the nasal passages to drain away tears. This will have to be removed, usually between four and six weeks after the initial surgery.

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Which Type of Surgery Is Best for Me?

Your specialist will assess your specific situation and needs and work with you to determine the most appropriate form of watery eye treatment. Often, endoscopic DCR is recommended because it has the same result as a traditional DCR, but without any visible scarring. It also boasts a high success rate of around 85%.

However, depending on how severe your epiphora is, other options may be explored. Lester Jones surgery might be needed to essentially bypass the blocked drainage channels and form a new, reliable drainage system to take tears away from your eyes. Your specialist will be able to talk you through the exact nature of the procedure they decide will produce the best results and answer any questions you have about it.

Before the Procedure

Your specialist will advise you on steps and recommendations to follow in the build-up to your procedure. In most cases, patients are encouraged to avoid certain painkillers – aspirin and ibuprofen – in the days leading up to surgery and not eat or drink in the six hours prior to their appointment. You should also arrive around one to two hours before surgery time for final checks and consultations.

If you’re having a DCR procedure, note that it may last up to 90 minutes and can involve the use of either general or local anaesthesia. This helps to ensure that you experience minimal pain and discomfort.

Aftercare – What Is the Recovery Process Like?

Proper aftercare is essential to hasten and simplify your recovery after surgery. It’s important to get plenty of rest, especially in the immediate hours after the procedure as the anaesthetic wears off. Depending on your age and health condition, you may be discharged the same day or need to spend a night under observation before going home.

You shouldn’t drive after the surgery, so arrange for a friend or family member to take you home, and avoid using heavy machinery, taking sedatives, or consuming alcohol for at least the first 24 hours. It’s also wise to avoid any hot foods or drinks for that first day, as they could trigger bleeding around the surgery site.

As for recovery times, it can take several weeks (up to six, on average) for full healing. You may experience some swelling and bruising around the affected area during that time. You’ll have a follow-up appointment a week or two after the operation to track your progress, and if you had an external DCR, your stitches will be removed at this point.

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FAQ

What are the risks and side effects of watery eyes surgery?

There are always risks to surgical procedures Patients who undergo a DCR could experience bleeding, blockages that need follow-up surgery, infection, or, in very rare cases, displacement of the tube that is supposed to drain tears from the eyes. Noticeable scarring is also possible with external DCR, though these scars should fade over time.

Is epiphora surgical treatment painful?

Endoscopic DCR is typically not painful and it is unusual to require any more than paracetamol. External approach DCR can be more uncomfortable. The discomfort will typically last for 1 week.

Will I have scars after the treatment?

If you have an external DCR, you may notice some light scarring on the nose, though this should fade with time, care, and massage. Many patients see their scars disappear within a year after their operation.

What kind of anaesthesia is used?

Either local or general anaesthesia may be used, according to the patient’s needs.

How long does it take?

A DCR procedure can take up to 90 minutes, though many are complete in about an hour.