Tearing

The tear film on the surface of the eye is a critical component of maintaining vision. Tears nourish and lubricate the surface of the eye as well as wash away debris. A smooth, balanced tear film also allows light to enter the eye in an optimal fashion. If there is a disturbance of the tear film, patients will often experience tearing, burning, irritation and most importantly blurred vision. Patients who experience tearing either have a problem with tear production or tear drainage.

Unfortunately, inflammatory conditions like rheumatoid arthritis, Sjogrens disease as well as aging and menopause lead to decreased tear production. As tear production diminishes, the surface of the eye starts to dry out. Some patients with dry eyes note tearing of the eyes during activities like reading, driving, watching TV, using a computer or going outside on a windy day. The treatment for dry eyes includes replacing tears with artificial lubricants which can be bought over the counter, medications that decrease inflammation in tear glands and encourages natural tear production to resume and finally a simple procedure to plug the tear drain. Other causes of increased tear production exist like allergies, infections and eyelashes poking the eye.

An obstruction of the tear ducts may occur due to numerous reasons (aging, trauma, inflammatory conditions, medications and tumors) and cause numerous signs and symptoms ranging from wateriness or tearing to discharge, swelling, pain and infection. These signs and symptoms may result from the tear drainage system becoming obstructed at any point from the tear passageway to the nasal cavity.

If the tear passageways become blocked, tears cannot drain properly and may overflow from the eyelids onto the face as if you were crying. In addition to excessive tearing you may also experience blurred vision, mucous discharge, eye irritation, and painful swelling in the inner corner of the eyelids.

Depending on the cause of your symptoms and their severity, we will suggest an appropriate course of treatment. In mild cases, warm compresses and antibiotics may be recommended. In other cases, surgery to bypass the tear duct obstruction, called a dacryocystorhinostomy (DCR ) may be recommended.

A DCR is performed by creating a new tear passageway from the corner of the eye to the nose, bypassing the obstruction. A small silicone tube called a stent may temporarily be placed in the new passageway to keep it open during the healing process. In a small percentage of cases, the obstruction is between the eyelid and the nose In these cases, in addition to the DCR procedure, it may be necessary to insert a tiny artificial tear drain called a Jones Tube. A Jones Tube is made of Pyrex glass and allows tears to drain directly from the eye into the nose.