Are you suffering from watery eye?


Watery eye is relatively common. It can occur in any ages.  Whilst many associate it with allergies or conjunctivitis, the causes may be many and sometimes multifactorial.   The severity ranges from those with welling of tears in the eyes, those lifestyle severely affected by tears. People complains of inability to see clearly to drive or read , experiences social embarrassment as ‘cry ‘ in a not appropriate circumstances.

Causes

There is a big variety of causes associated with this condition. It can be divided into overstimulation and under -drainage.

Causes of too much tear production include blepharitis, eyelid malposition such as ectropion or entropion (eyelid turning in or out) , trichiasis ( misdirected lashes) or epiblepharon ( fold of lashes touched onto eyeball). Another cause of watery eye is dry eyes as neural stimulation sent from dry eye to the brain will cause more tears being produced as compensation.

For the pathologies which lead to under-drainage, that include punctal stenosis (blockage of drainage holes in the eyelid), canalicular obstruction, lacrimal sac stones or tumor or most commonly nasolacrimal duct obstruction.

It is important to note that watery eyes can also occur in children.  Epiblepharon is high up in the list of causing the watery eye in Malaysian population that Dr Ho see.  Parents need to be observant and will note that the lower eyelashes that close to the nose rolls in and touch the cornea.  As usually the eyes involved become a bit insensitive, patient may not complained.  If left untreated, it may be associated with corneal scarring and ambloypia.  

mucocele

mucocele-- dilated lacrimal sac with collection of secretion

 

  • mucocele

    mucocele-- dilated lacrimal sac with collection of secretion

     

Provided Physiotherapies

Treatment

Depending on the causes, the treatment ranges from eyelid hygiene for blepharitis, tears supplement for dry eyes, epilation or electrolysis for triachiasis, surgical correction for entropion/ectropion and dacryocystorhinostomy (DCR) for patient with blocked nasolacrimal duct. For those who has injury to canaliculus secondary to injury or infection, a Lester Jones tube is a possibility to restore the function.

immediately post op wound

one month post surgery with hardly visible wound

entropion wound with lashes curled inside (no lashes visible but poke into eyes)

post op with all the lashes curled out.  The scar will slowly fade.

Pre op: This lady presented with a lump and watery eye

Post op:  This lady has a DCR on the right side of the nose, histology showed angiolymphoid hyperplasia.  The wound healed well and there is no known recurrence

 

Pre op: left watery eyes with tear pouring out

Post op: Both eyes look good with minimal visible scarring

 

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