There are many causes of watering eyes.
Some patients have dry eye which means they have reflex watering. But I’m going to concentrate on the cause of watering eyes for which we have a surgical solution. That is a blocked tear duct.
The tears drain from the eye down into the back of the nose and sometimes with all the pollution and inflammation inside the nose that tear duct gets narrower and gets blocked. So, patients get watering eyes, particularly when they go outside in the wind.
If a patient’s referred this to me, like you have for your watering eyes, first of all I ask you lots about the symptoms – what time of the day is it? Is it indoors or outdoors? Summer or winter? Whether other people remark on it? Is there a blurred vision?
Then I have to examine you. I’ll have a look at the height of the tears, see whether they’re up or down. I’ll look at the tearsacks and see if it’s inflamed and I’ll look if the tears are draining at the right rate or whether they are delayed.
Then we have to do some small procedures which are really diagnostic. They are syringing and that’s done under little light drop of local anaesthetic onto the eye. I very gently put a cannula into the tear duct and syringe for some saline to feel the pressure that I’m using to syringe down and see whether you taste the saline at the back of your throat or whether the most of it comes back gushing over the eye. That gives me a very good idea of whether you’ve got a blocked tear duct. If it’s completely blocked, of course, all of that saline comes back over the eye.
I also have to look in the nose. This is because the nose is where the tears drain too. Sometimes, people have a pathology within the nose which I have to identify and treat if necessary. If I plan a surgery I may want to do the tear duct surgery through the nose. That’s the endoscopic endonasal DCR. I have to establish whether there’s enough space in there to put the very fine instrument and lights.
There are two types of DCR, in fact three.
Ms Jane Olver is the founder of Clinica London and a Consultant Ophthalmologist and Oculoplastic Surgeon. Her special expertise is in oculoplastic and cosmetic eye surgery including eyelids and lacrimal surgery. She is specialised in endoscopic lacrimal surgery for watering eyes in adults and children. She has over 20 years’ experience in treating people with eye problems just like you, and has published extensively in scientific journals about Ophthalmology and Lacrimal Surgery and is the author of the books “Ophthalmology at a Glance” and “Colour Atlas of Lacrimal Surgery”. At Clinica London, she is responsible for the Aesthetic Medicine and Surgery part, as well as patients with eye, eyelid and tear duct problems, and acute eye problems.