Watery Eyes Treatment

Watery Eyes Treatment

London

At The Ezra Clinic, we understand the challenges and discomfort caused by watery eyes, known as Epiphora. Our clinic, led by renowned experts, offers personalised and effective solutions to address this condition.

By choosing The Ezra Clinic, patients benefit from our commitment to utilising the latest treatment advancements and a compassionate approach that focuses on individual needs. Our experienced team is dedicated to providing relief and improving the quality of life for those suffering from watery eyes, ensuring a thorough understanding and treatment of the underlying causes.

What does watery eyes mean?

The human body naturally produces tears to properly lubricate the eye and help rid it of unwanted elements. However, in certain people, the eyes can produce excessive tearing and develop watery eyes. Watering eyes, medically known as epiphora, is a very common problem that describes an imbalance between tear production and tear drainage. The failure of the tear-drainage system to drain tears from the eye into the nose adequately is a common cause.

The problem can affect anybody of any age, though it is most common at extremes of age: in children and older people. While this condition may seem minor, it can cause irritating symptoms such as stickiness and redness.

The condition’s treatment methods range from self-help measures, such as medicines and eye drops, to corrective surgery of the tear ducts where necessary.

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What causes watery eyes?

Watery eyes, or Epiphora, are often caused by an imbalance between tear production and drainage. It’s normal for eyes to water in response to irritants or eye infection, such as having an eyelash stuck in the eye or being near smoke. Unfortunately, constant watering and producing too many tears is not normal.

Key causes include:

Increased Tear Production: Often triggered by allergies, infections like conjunctivitis, or dry eye syndrome.
Impaired Tear Drainage: This can be due to a blocked tear duct, issues with the tear drainage opening (punctum), or eyelid problems such as laxity affecting the tear drainage pump.
Eyelid Abnormalities: Ectropion (eyelid drooping away from the eye) and Entropion (eyelid turning inwards) can also lead to watery eyes.

Symptoms of watery eyes

Whilst the symptoms can sometimes be harmless, many patients complain that watering eyes can cause discomfort and severe eye pain.

Symptoms of watery eyes include:

Blurred Vision: Compromised clarity of sight.
Sore and Irritated Eyelids: Discomfort around the eye area.
Sticky Eyes: A feeling of adhesiveness in the eyes.
Social and Emotional Impact: Embarrassment caused by the misunderstanding and mistaking the condition for crying.

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What treatment is available for watery eye?

If persistent watery eyes impact your daily life, seeking medical attention is advisable.

Non-Surgical Treatments

Initially, consulting with a GP or optician is recommended to identify the cause. If symptoms are mild, self-care approaches like using special cleaning solutions, eye drops, artificial tears, or prescribed medicines for allergies can effectively manage the condition. This approach allows individuals to alleviate symptoms without the need for invasive procedures.

Surgical Treatments

Surgical treatments for watery eyes are considered when non-surgical methods are insufficient. Should the cause remain unclear, an ophthalmologist’s examination may be necessary, as treatment varies based on the underlying issue. In cases of blocked or dysfunctional tear ducts, surgery might be required, tailored to the specific obstruction.

Surgical treatment for watery eyes

At The Ezra Clinic, we offer a comprehensive range of treatments for watery eyes, including Lester Jones tube surgery (a glass tube placed between the corner of the eye and the nose) where necessary. Our other surgical options depend on the individual’s needs.

Dacryocystorhinostomy (DCR)

Dacryocystorhinostomy, more frequently known as DCR, is the most common form of surgery in our London eye practice. It aims to restore the correct flow of tears by creating a new drainage connection into the nose, which allows the tears to bypass a blocked nasolacrimal duct. This can be performed using a conventional or ‘external’ approach, leaving a small faint scar on the side of the nose.

Endoscopic DCR

Recent technological advances have made an internal surgery approach possible, known as Endoscopic or ‘Endo’ DCR. It involves using a specialised telescope (endoscope) to allow the entire operation to be performed through the nose without leaving any scars on the skin.

In both cases, a small polythene rod is sometimes placed inside the nose to create a new drainage passage. These will be removed 4-6 weeks after the watery eye surgery in an outpatient procedure.

Download the Patient Information Leaflet

DACRYOCYSTORHINOSTOMY (DCR) PDF

Which type of surgery is best for me?

Your specialist eye surgeon will assess your symptoms and medical history to determine the most suitable surgical option for you.

Endoscopic DCR surgery leaves no visible scar, while scars from external DCR typically fade over several months. these surgeries are highly successful with success rates of 85% or above. In some more coplex cases, further surgery may be required in the for of placement of a Lester Jones Tube. A Lester Jones Tubes is a glass tube which is permanently places to connect the corner of the eye with the nose to bypass the blocked lacrimal system.

Before surgery

Patients are advised to avoid Aspirin or Ibuprofen for two weeks prior to surgery and to refrain from eating or drinking for at least six hours beforehand. On the surgery day, patients should arrive 1-2 hours early for final checks and consultation with your consultant and the anaesthetist.

DCR procedures, which can last 1-1.5 hours, are performed under general or local anaesthetic with sedation, depending on the patient, ensuring minimal discomfort. If the patient is under local anaesthetic, they should not feel much discomfort during the procedure.

Post-surgery & Aftercare

After surgery, it is essential for patients to rest and allow the effects of the general anaesthetic to wear off before attempting to resume normal activities. The recovery process begins immediately post-surgery, and certain precautions are required during this time.

Older patients might require an overnight stay in the hospital for monitoring purposes, whereas most younger patients are often discharged on the same day. All patients must arrange for transportation home by a friend or relative, as public transport is not advisable, and driving is strictly prohibited.

During the first 24 hours post-surgery, patients should adhere to the following guidelines:

Avoid driving, consuming alcohol, taking sedatives, or operating machinery.
Refrain from hot food and drinks to prevent post-operative bleeding.

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Aftercare

The aftercare process is vital for a smooth recovery and involves several steps:

Patients are recommended to rest and are generally advised not to return to work for a week to avoid strenuous activities.
It is normal to experience some nose bleeding post-surgery. However, immediate medical advice should be sought if the bleeding is excessively heavy. Additionally, patients should avoid blowing their nose for at least 7-10 days to minimize the risk of further bleeding.

In the case of external DCR surgery, patients may have a bandage on their eye and the side of their nose, which should be removed the day after the surgery. This bandage may make wearing glasses uncomfortable until it is removed. There will also be dissolvable stitches on the nose, which might cause temporary discomfort while wearing glasses.

Patients can remove the dressing themselves at home the day after the surgery. They should gently wash the area without rubbing it dry. Ice packs can be applied to help reduce swelling, bleeding, and bruising. For pain management, paracetamol or codeine is recommended, but patients should avoid Aspirin or Ibuprofen for two weeks.

Post-operative eye watering is common and may continue for several weeks as the inflammation and swelling decrease. Rod removal will occur at a later stage in the recovery process.

For medication, eye drops are prescribed four times daily after both types of surgery. In addition, a nasal spray may be given to Endo DCR patients to loosen any scabs or crusts inside the nose. This treatment should begin five days post-surgery and continue for three weeks.

What are the risks?

As with all surgical procedures, there are risks and these will be discussed with you during consultation. Risks include bleeding for up to ten days following surgery (1 in 50 people) and infection, blockages which require further surgery, or the displacement of the tube from the nose – though these risks are much rarer.

When undergoing external DCR, most patients will notice a small scar on the side of the nose, but this will usually disappear after some months. In some cases, it may need to be massaged, though.

Follow-up

Patients will need to book a follow-up appointment for 1-2 weeks after surgery. With those who have undergone external DCR, the stitches will be taken out at this consultation, while the rods inside the nose will be removed after six weeks. Patients should come back again for a final progress review after six months.

Most patients are extremely happy with the results of their watery eye procedure. The success rate for DCR – that is the eyes no longer excessively watering – is 90-95%. This may lower to 70-80% in more complex cases.

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