Causes
- Excessive tear production – rare, may be seen in dry eye (drying of the eye leads to increased secretion of tears)
- Lid malposition causing punctal malposition – mild ectropion causes pooling and overflow of tears
- Punctal stenosis – watering eye and non-visible punctum
- Blockage of the lacrimal sac/nasolacrimal duct
Treatment
Depends on cause:
- lid malposition corrected surgically
- punctal stenosis treated by surgical dilation or opening under local anaesthesia
- Blockage of nasolacrimal duct – syringing or dacryocystorhinostomy (hole made from nose to lacrimal sac to bypass obstruction)
Paediatrics
- In children tear drainage system may not be patent (watery eyes and conjunctivitis)
- Treatment: chloramphenicol eye drops and parental massage of lacrimal sac.
- Usually spontaneous resolution, if this has not occurred by 12-24 months syringing and probing under local anaesthesia.