If you find you have a problem with constantly tearing – watering eyes, it’s usually because of excessive tear production, or poor tear drainage. While tears are a natural lubrication for the eyes, excess tearing can lead to discomfort, infection, and blurred vision. While not necessarily harmful, watery eyes can be troublesome and irritating. Michael Neimkin, M.D., at the Ophthalmic Plastic and Cosmetic Surgery Center in Atlanta, GA, urges his patients to react to any discomfort promptly.
Tears normally drain into small holes located in the inside corner of the upper and lower eyelids and then through the body’s tear drainage system. The tears are pumped through this drainage system by the opening and closing of the eye. A blockage in any part of this drainage system can prevent tear drainage and lead to excess tears running out of the eye and down the cheek.
Babies can be born with a congenitally blocked tear duct. It is estimated nearly 20% of newborns have this condition. It usually resolves on its own within four to six months. In adults, the obstruction can result from an eye infection, swelling, injury or a tumor.
Diagnosis of Tearing – Watering Eyes
To diagnose the nature of the blockage, Dr. Neimkin employs a number of tests, including a complete medical eye exam. As part of the examination Dr. Neimkin places a harmless orange dye in the eye to isolate the blockage. A thin metal tube will then be placed into the tear drainage system in order to see if the tubes leading into the tear sac are open. He will then attempt to flush water through the nasolacrimal duct into the nose in order to determine if the duct is open. This leads to the proper diagnosis. Other tests may include an X-ray or CT scan of the tear duct area.
After diagnosis, Dr. Neimkin will partner with the patient to commit to one of the following blockage treatment options:
- Dacryocystorhinostomy (DCR) hole between tear sac and inside of nose: When the nasolacrimal duct is blocked a DCR is usually required. During this procedure, a hole is created between the tear sac and the inside of the nose. DCR is a same-day procedure. Patients can choose to be either asleep under general anesthesia or awake with sedation.
- Dacryocystorhinostomy (DCR) skin incision on side of the nose: A DCR is performed through a skin incision allowing the bone between the tear sac and the nose to be removed. The lining of the tear sac is then attached to the lining of the nose to form a permanent drainage for tears.
- Dacryocystorhinostomy (DCR) through the nose: A DCR can also be performed through the nose, referred to as an endoscopic DCR. This avoids a skin incision. However, the success rate with this procedure is probably less than when the procedure is performed through the skin because the tear sac is not directly attached to the lining of the inside of the nose.
In some people, during surgery, a clear plastic tube is placed from the inside corner of the eye into the nose. The tube is used to stent the tear drainage system and prevent scarring. This tube is removed in our office in two months. When the drainage tubes, called canaliculi, are blocked, surgical therapy is more complicated. In most cases, both a DCR and reconstruction of the canaliculi will be performed.
Each patient is unique; therefore, results will vary.
To determine if corrective surgery for tearing – watering eyes is required, call (404) 946-8323 or complete our contact form to schedule a consultation with Dr. Neimkin at the Ophthalmic Plastic and Cosmetic Surgery Center. Dr. Neimkin and his staff take pride in offering patients the highest level of care in a family-like environment. Our office serves patients in the metro Atlanta, GA area including the surrounding communities of Sandy Springs, Buckhead, Dunwoody and Roswell. We look forward to helping you soon.