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Watering eye, blocked tear duct, styes and chalazia

An eye that waters all the time is more than a nuisance. Tears run down the cheek, blur your vision, make the skin sore and get in the way of reading, driving and work. Many people put up with it for years, wiping their eyes with a handkerchief. In most cases the cause can be found and treated. This page explains why eyes water, how a blocked tear duct is treated, and how styes and chalazia, the common lumps in the eyelid, are handled.

How do tears drain?

Tears are made all the time to keep the eye moist. They spread across the eye when you blink and drain away through two tiny openings at the inner corner of the upper and lower eyelids. From there they flow through small channels into the tear sac, which sits beside the nose, and then down the tear duct into the nose. That is why your nose runs when you cry. If any part of this path is narrowed or blocked, tears spill over the lid instead.

Why does my eye keep watering?

There are two main groups of causes.

Too many tears

• Dry eye. It sounds odd, but a dry, irritated eye often makes floods of reflex tears. This is one of the most common causes of watering; see what causes dry eyes.
• Eye allergy, infection or irritation, including dust, wind, smoke and Goa's sea breeze on a two-wheeler.
• Eyelashes that rub on the eye, or something stuck under the lid.
• Inflammation of the lid margins (blepharitis).

Tears not draining

• A blocked tear duct, the most common drainage problem in adults.
• Narrowed openings at the inner corner of the lids.
• A loose or out-turned lower eyelid with age, so that tears do not reach the drainage openings.
• Weak blinking, for example after a facial palsy.

The treatment depends entirely on the cause, which is why the eye needs examining before anything else is tried.

What is a blocked tear duct?

In adults, the tear duct usually narrows slowly with age, and it is more common in women. Long-standing nose or sinus problems, an old injury to the nose or face and past infections can also block it. Signs include:

• watering of one or both eyes, often worse in wind and cold air
• a sticky discharge, with lashes stuck together in the morning
• blurred vision from a film of tears
• a small swelling at the inner corner of the eye, and sometimes mucus or pus coming back into the eye when it is pressed

When the tear sac behind a blockage gets infected (dacryocystitis), the inner corner becomes red, swollen and painful, sometimes with fever. This needs to be seen the same day; emergency eye care at ReNew Vision is available 24 hours. See eye emergency.

How is the cause found?

1. The eye doctor asks how long the eye has watered, whether it is sticky, and about allergies, nose problems and past injuries.
2. The lids, lashes, tear film and the surface of the eye are examined under magnification, to look for dry eye, blepharitis, lid position problems and lashes rubbing the eye.
3. The drainage openings are checked.
4. If a blockage is suspected, salt water may be gently flushed through the drainage channel with a fine, blunt tube after a numbing drop (syringing). If the water reaches the nose and throat, the duct is open; if it comes back, it is blocked.

How is a watering eye treated?

• Dry eye, allergy and blepharitis are treated with lid care, drops and advice, as the eye doctor prescribes.
• An infected tear sac is treated with medicines first, as prescribed, and the blockage is dealt with afterwards.
• A blocked tear duct in an adult is usually treated with DCR surgery (dacryocystorhinostomy), which makes a new path for tears from the tear sac into the nose. DCR surgery is done at ReNew Vision. Read DCR surgery for a blocked tear duct: what to expect.

A blocked tear sac should also be treated before cataract surgery, because an infected sac raises the risk of infection inside the eye after the operation. If you are planning cataract surgery and have a watering, sticky eye, mention it at the check-up.

What about watering eyes in babies?

Many babies are born with a tear duct that has not fully opened. The eye waters and gets sticky from the first weeks, though the white of the eye stays white. In most babies this clears by itself by the first birthday. Until then:

• clean the lids gently with cotton wool dipped in boiled, cooled water, wiping from the inner corner outwards
• massage the area beside the nose as the eye doctor shows you
• see the eye doctor if the eye turns red, the corner swells, the baby seems in discomfort in light, or the watering has not cleared by about the first birthday

If a baby needs a procedure to open the duct, it is arranged by referral. Large, cloudy, watering eyes in a baby are different and need an urgent check, because they can be a sign of childhood glaucoma; see children's eye care.

Styes and chalazia

A stye is a red, tender bump at the edge of the eyelid, caused by infection at the root of an eyelash. A chalazion is a firm lump further into the lid, caused by a blocked oil gland, which usually does not hurt and can last for weeks. Both are common, and both usually get better with warm compresses and lid cleaning. Never squeeze or prick them. Treatment of styes and chalazia is done at ReNew Vision. If a chalazion does not settle, the eye doctor may advise a small procedure to drain it. Read stye or chalazion: what is this lump on my eyelid?

What is not done here?

Surgery for a drooping eyelid (ptosis), removal of eyelid growths and cosmetic eyelid surgery are not done at ReNew Vision. An eyelid lump that keeps growing, bleeds, makes lashes fall out, changes the shape of the lid or comes back in the same place needs to be examined; if it may be a growth rather than a chalazion, the eye doctor refers you for further tests and treatment.

How do I book?

• Where: ReNew Vision Eye Hospital, 2nd floor, Pai Hospital building, Vaddem Merces Road, Vaddem, Vasco da Gama, Goa 403802. See timings and directions.
• When: Eye OPD Monday to Saturday, 4 pm to 7 pm. Sunday OPD closed. Emergency eye care: 24 hours.
• Call or WhatsApp: 072489 88039.
• Bring: a list of your medicines, including any eye drops you have tried, and earlier eye or nose reports.

Watering eye and eyelid guides

Questions patients ask

Why does my eye keep watering?

The two main causes are too many tears, often from dry eye, allergy or irritation, and tears not draining, usually because of a blocked tear duct or a loose lower lid. The treatment depends on the cause, so the eye needs examining first.

Can a blocked tear duct clear by itself?

In babies it often does, usually by the first birthday. In adults, a fully blocked duct rarely clears on its own, and DCR surgery is the usual treatment if the watering is troublesome or the sac gets infected.

Is DCR surgery done at ReNew Vision?

Yes. DCR surgery for a blocked tear duct is done at ReNew Vision after an examination confirms where the blockage is.

Is drooping eyelid surgery done at ReNew Vision?

No. Ptosis surgery, removal of eyelid growths and cosmetic eyelid surgery are not done here. The eye doctor examines the eyelid and refers you if you need one of these.

My baby's eye waters and is sticky. What should I do?

This is usually a tear duct that has not fully opened, and it often clears by the first birthday. Clean the lids with boiled, cooled water and see the eye doctor, who can show you how to massage the area. Come sooner if the eye turns red or the corner swells.

This page is general eye-health information, not personal medical advice. Your eye doctor advises you after examining your eyes.