Watery Eyes in Infants
A watery eye occurs when tears normally produced cannot flow away from the eye properly. As a result, tears pool on the surface of the eye and fall down the cheek. The eyelids may also stick together after sleeping and develop recurring discharge.
How do tears drain away from the eye ?
Tears are removed through two small openings located on the upper and lower eyelid margins close to the nose. The tear fluid then travels towards the lacrimal sac and eventually empties into the back of the nose. This is why your nose runs when you cry.
What prevents the tears from being drained away from the eye ?
A membrane stretching across the lower end of the tear duct normally causes the watery eye in infants. At birth or just prior, this membrane normally opens up. However, in many infants it is still closed over at birth, which prevents the tears being drained away from the eye. Approximately one third of all infants are born with a watery/sticky eye. The tear duct may spontaneously open over the first 12 months of age or may require treatment.
How is a watery eye treated ?
Initially your doctor may recommend antibiotic eye drops to use as well as gentle massage. This expresses mucus and tears from the sac. Most tear blockage in infants disappears by six months of age. If tearing persists, it may be necessary for the eye doctor to open the teat ducts by a surgical procedure called “probing”.
How is probing of the tear ducts performed ?
Probing the tear ducts in infants is a surgical procedure that is performed while the child is asleep (under a general anaesthetic). A thin blunt metal wire is gently passed through the tear duct to open up any obstruction. Infants usually experience no pain after probing but some blood staining of the tears or nasal secretion is common and a discharge from the eye may be present for up to a week. Blockage of the tear duct can recur and may require another probe.
Watery Eyes in Adults
Q. My eyes are watery. Could the tear ducts be blocked?
A. The eyes may water either because an irritation may cause excess tears forming in your eyes (peeling an onion for example), or due to the normal amount of tears not draining from the eye properly. Blocked tears duct is only one of the causes of watery eyes.
Q. How do I know if I have a blocked tears duct?
A. The doctor will need to examine your eyes. He may need to flush your tears duct. Some patients may need to have a xray examination to try and determine the cause of the blockage.
Q. Will I need an operation?
A. You will need your eyes to be examined first to determine the cause of the watery eyes. Most patients do not need an operation. Some patients will need a small procedure in the treatment room in the clinic. If there is a blockage of the tear duct, an operation will need to be performed in hospital.
Q. What does this operation involve?
A. Most patients with blocked tear duct will need an operation called DCR (DacryoDystoRhinostomy) . Most commonly it is performed with sedation in the vein and local anaesthetics is used for the procedure. During the surgery a small piece of bone will be removed to create a new connection between your tear sac and the nose. A thin plastic tube may be inserted in the inner corner of the eye, going down to your nose to act like a stent, to keep the new junction open. That plastic tube will be taken out few months later in the clinic.
Q. How is the surgery done?
A. DCR can be done either through the nose (endoscopically), or through a small cut in the skin close to the inner corner of the eye which usually heals very well. There are advantages and disadvantages for each way.
Q. What are the risks?
A. Success rate is usually about 90%, being slightly higher for DCR through the skin than through the nose. Failure rate is about 10%. Other possible risks include bleeding, bruising, scarring and reaction to anaesthetics. The risk of dying from the anaesthetic is extremely rare.
Q. How long do I need to stay in the hospital for?
A. If everything goes ok and there is someone at home with you the night after the surgery, who is able to drive, you may go home the same day. Otherwise you may need to stay in the hospital for one night.