Watering eyes from the outdoors
When we go outside our eyes will often water. This can be a very brief watering, which settles once we are accustomed to the temperature. In some people watering eyes outside can be troublesome when it is due to a narrowing of their tear ducts.
You may not realise that there are two tiny tear duct openings at the corners of each eyelid towards the nose, which catch the tears on each blink. These are called “puncta” because they are so small, like a punctuation full stop mark. The tears then go down through the delicate channels called the canaliculi into the lacrimal sac, which is just below the corner of the eye at the side of the nose.
The lacrimal sac is buried where it mostly cannot be felt or seen unless it is inflamed with acute dacryocystitis or enlarged with a mucocele i.e. full of mucus. The lacrimal sac then drains down into the back of the nose via the nasolacrimal duct. The opening of the nasolacrimal duct is inside the nose but deep enough that the tears do not drop out of the front of the nose but trickle back down the throat.
Nasolacrimal duct obstruction is very common with:
- mucosal wear and tear
- inflammation from recurrent infections or sinusitis
- inflammation from chronic irritation by pollutants and dust
- gradual narrowing with age.
You know that you may be getting tear duct narrowing when you suffer gradually more and more from watering eyes when you go outside in the cold.
Many of my patients play golf. When they are outside in the cold and looking down at the little white golf ball on the tee, their tears well up along the lower lid and then spill over causing blurred vision and an appearance as if they are crying. It spoils their game. These patients mainly need something done because it affects their hobbies. They will often also notice watering when they are looking down reading a book.
Watering eyes outside can be a warning to you that you are beginning to get a narrowed nasolacrimal duct. If this gets progressively narrower and constricted the tears will get progressively worse when outside and eventually become more continuous even when inside.
Fortunately, there is some good news as there are operations to cure watering eyes, called a dacryocystorhinostomy or DCR for short.