Watery Eyes (Epiphora): Causes, Symptoms & Treatment

Watery eyes happen either because your eyes produce too many tears or because tears aren't draining away properly. Common causes include allergies, dry eyes, conjunctivitis, blepharitis, a blocked tear duct, corneal abrasions, styes, chalazia, and environmental irritants like wind, smoke, or dry air. Save Sight Centre can pinpoint the exact cause with a focused eye exam.

This sounds contradictory, but it's a genuinely common pattern: when your eyes are too dry, they trigger a reflex response that floods the surface with watery tears to compensate. These reflex tears don't have the right oily and mucous components to properly lubricate the eye, so the underlying dryness continues even as the eye appears to be watering excessively.

Lacrimation is the normal, healthy production of tears that happens automatically to protect and lubricate your eyes, including when you're crying or laughing. Epiphora is the medical term for abnormal, excessive tearing — either because too many tears are being made or because they aren't draining away properly, causing them to overflow and run down your face.

Watery eyes affecting just one eye (called unilateral epiphora) often point to a localized cause on that side, such as a blocked tear duct, a foreign object, an eyelid abnormality like entropion, or a corneal scratch. Both eyes watering together (bilateral epiphora) more often suggests a broader cause like allergies, dry eyes, or environmental irritation.

Diagnosis starts with a slit-lamp exam to check the eye's surface for inflammation, foreign bodies, or abrasions. Your doctor may also do a dye disappearance test, where colored drops are placed in the eye to see how well they drain, along with allergy testing if an allergic cause is suspected. In chronic or unclear cases, imaging like dacryocystography or a CT scan may be used to check for a blockage in the tear duct system.

Treatment depends entirely on the cause. Allergies and dry eye respond to antihistamine or lubricating eye drops; infections need antibiotic or antiviral treatment; a blocked tear duct may need gentle massage (in infants), probing, saline flushing, or a surgical procedure called DCR in more persistent adult cases; and eyelid abnormalities or corneal injuries are treated directly. Many mild cases also resolve on their own once the trigger, like an allergy season, passes.

Dacryocystorhinostomy (DCR) is a surgical procedure that creates a new drainage pathway for tears when the natural tear duct is blocked and can't be cleared with simpler methods like probing or flushing. It's typically considered for adults with a persistent, confirmed blockage that hasn't responded to more conservative treatment.

Yes, this is one of the most common patterns seen with eye allergies. Exposure to allergens like pollen, dust mites, or pet dander triggers histamine release in the eye, causing itching, redness, swelling, and watering together — often worse during seasonal changes. Antihistamine eye drops and avoiding known triggers typically bring good relief.

Yes, fluctuating blood sugar levels can affect tear production and corneal sensitivity, sometimes leading to irritation and reflex watering in people with diabetes. Keeping blood sugar well controlled, along with regular eye exams and appropriate lubricating drops, helps manage this alongside your broader diabetes care.

Yes, a vitamin A deficiency can contribute to dry eye, which paradoxically triggers excessive reflex tearing as the eye tries to compensate. Low omega-3 fatty acid intake can also affect tear quality and lead to irritation. If a deficiency is suspected, this is best addressed with your doctor's guidance rather than self-prescribed supplements.

Mild, persistent watering in newborns is fairly common and usually caused by an immature or narrow tear duct that hasn't fully opened yet — this often resolves on its own within the first year, sometimes helped along by gentle massage shown by your pediatric eye doctor. Watering accompanied by redness, swelling, or discharge should be evaluated promptly, since it could indicate an infection.

See an eye doctor if your eyes water constantly rather than occasionally, if you have eye pain, swelling, or a visible lump, or if watering is affecting your vision. Go to the emergency room immediately if watery eyes follow an injury to the eye or if you experience sudden vision loss in one or both eyes.