Watery Eyes: Causes of Excessive Tearing and Treatment
Watery eyes come either from too much tear production or from a blocked drainage path to the nose. Here we explain the causes, the irrigation test for diagnosis and DCR surgery.
Watery eyes have two main causes. Either the eye produces too many tears (wind, cold, a foreign body, allergy, infection or dry eye), or the drainage path to the nose is blocked. The blockage can sit in the tiny tear openings of the eyelid (punctum) or in the duct leading to the nose. We diagnose it with an irrigation test. For a blocked duct, DCR surgery creates a new drainage path for the tears. For a narrowed punctum, however, smaller procedures may be enough.
Where do tears go when you have watery eyes?
The lacrimal gland produces tears under the upper outer corner of the eyelid. Blinking spreads them across the surface. Then they drain through two tiny openings (puncta) in the upper and lower eyelids at the inner corner of the eye. From there, thin canals carry them to the tear sac, and then into the duct that opens into the nose. For this reason, your nose also runs when you cry.
“We can compare the tear system to a tap and a sink. Either the tap is open too wide, or the sink's drain is blocked. The treatment depends on which one it is.”
— Prof. Dr. Fırat Helvacıoğlu, from his video
If your eyes are watering
Prof. Dr. Fırat Helvacıoğlu explains why eyes water and how we treat it.
Why eyes water: the tap and the drain
The gland in the upper outer corner secretes tears. After they moisten the eye, they flow through the small openings (puncta) at the inner corner into the sac, and then through the duct into the nose. Watering comes either from excess secretion or from a blocked drain.
- Normal flowTears produced and tears drained stay in balance, so the eye stays moist but does not overflow.
- Excess secretionWind, cold, a foreign body, allergy, infection or dry eye increase tear secretion.
- Blocked drainA narrowed punctum or a blocked nasolacrimal duct makes tears spill over the cheek.
Excess tear production behind watery eyes
- Environmental factors: Wind, cold air, smoke
- A foreign body or an eyelash poking the eye
- Allergies and infections: Together with itching, redness and discharge
- Dry eye: A dry surface reflexively produces plenty of tears, but of poor quality
- Eyelid problems: Eyelids turning outward or inward, and inflammation of the lid margin (blepharitis)
In these cases, treatment targets the underlying problem that causes the watering. I covered winter-related dryness and watering in the article “Why do your eyes get dry in winter?”
Tear duct blockage
A blockage can occur at different points along the tear pathway:
- Punctal stenosis: The openings that collect tears become narrow. It is common in older age and with chronic eyelid inflammation.
- Blockage of the duct leading to the nose (nasolacrimal duct): This is the most common cause in adults. Tears pooled in the sac can become infected, so swelling, redness and discharge may appear at the inner corner.
- Congenital blockage: It is common in babies. Most cases open on their own within the first year. If needed, we treat it with massage and a simple probing.
A 25-year population study in the United States found that tear duct blockage in adults was most common in women over 66.
Diagnosis: the irrigation test
First, the doctor examines the eye surface, the eyelids and the puncta. If a blockage is suspected, we perform an irrigation (flushing) test. Drops numb the punctum, and then a thin cannula delivers saline through it. If the saline reaches the throat, the pathway is open. If it flows back, there is a blockage, and the test shows where it is. The procedure takes a few minutes; thanks to the anaesthetic drops, most patients feel no pain, although a slight feeling of pressure may occur.
Treatment options
| Condition | Treatment |
|---|---|
| Excess secretion | Treating the cause: dry eye, allergy and eyelid inflammation |
| Punctal stenosis | Widening the punctum or a punctal plug with a hole |
| Blocked duct leading to the nose | DCR (dacryocystorhinostomy): the surgeon creates a new path from the sac to the nose |
| Infection of the sac (dacryocystitis) | Antibiotics first, then surgical treatment of the blockage |
DCR surgery has a high success rate. In the study mentioned above, external DCR operations reached a 94% success rate. For details, please see the page on tear duct blockage (DCR).
See a doctor without delay if you notice
- A painful, red swelling at the inner corner of the eye
- Discharge or pus from the inner corner when you press on it
- Constant watering with blurred vision in one eye
Frequently asked questions
Either the eye produces too many tears (wind, allergy, dry eye, a foreign body), or the drainage path to the nose is blocked. An examination and, if needed, an irrigation test reveal the cause.
Yes. A dry eye surface reflexively produces extra tears. For this reason, dry eye is one of the common causes of watering.
In babies, it often opens on its own within the first year. In adults, however, it usually does not resolve by itself, so treatment is needed.
It is an operation that creates a new passage between the tear sac and the nose. When the duct leading to the nose is blocked, it lets tears drain into the nose again.
Congenital tear duct blockage is common, and most cases open on their own. We recommend the massage your doctor shows you. However, if there is infection or no improvement by the age of one, an examination and a simple probing may be necessary.
Drops numb the eye first, and then the test follows. Most patients describe a mild feeling of pressure and fluid, and the procedure is short.
If the blockage does not open with medication or massage, and infection or constant watering impairs your quality of life, doctors consider surgical options such as DCR. You make the decision together with your doctor, based on the examination and irrigation test results.
These symptoms may point to conditions such as infection or tear duct inflammation. You need to avoid touching your eye, keep your hands clean and see an eye doctor soon.
Related pages
References
- Woog JJ. The incidence of symptomatic acquired lacrimal outflow obstruction among residents of Olmsted County, Minnesota, 1976-2000 (an American Ophthalmological Society thesis). Trans Am Ophthalmol Soc. 2007;105:649-666. PMID: 18427633.
- Craig JP, Nichols KK, Akpek EK, et al. TFOS DEWS II Definition and Classification Report. Ocul Surf. 2017;15(3):276-283. doi:10.1016/j.jtos.2017.05.008
This article is for patient information only; it does not replace an examination or medical assessment. We determine the right treatment after an eye examination and measurements. Publication date: 25 September 2026.
Contact Prof. Dr. Fırat Helvacıoğlu with your questions
Prof. Dr. Fırat Helvacıoğlu · Veni Vidi Eye Clinic, Bağdat Cad. No: 257, Caddebostan – Kadıköy / Istanbul