Watery Eyes Treatment at the Eye Lid Clinic

Clinic Overview:

  • Specialises in treating watery eyes (Epiphora) using latest treatment
    advancements with a gentle, compassionate, and personalised approach.

Understanding Watery Eyes (Epiphora)

Definition:

  • Excessive tearing due to an imbalance between tear production and drainage.
  • Common in children and older adults.

Causes:

  • Allergies, infections, dry eye syndrome.
  • Blocked tear ducts, punctum issues, eyelid problems.
  • Eyelid abnormalities like ectropion and entropion.

Symptoms of Watery Eyes:

  • Blurred vision.
  • Sore and irritated eyelids.
  • Sticky eyes.
  • Social and emotional impact.
  •  

Treatment Options

Non-Surgical:

  • Self-care: cleaning solutions, eye drops, artificial tears, medications.

Surgical:

  • Required when non-surgical methods fail.
  • Dacryocystorhinostomy (DCR): Creates a new drainage connection into the nose.
  • Endoscopic DCR: Internal surgery using an endoscope, leaves no scar.
  •  

Surgical Treatment Details

  • Types of Surgery:
  • External DCR: Leaves a small scar.
  • Endoscopic DCR: No visible scar, uses a silicone polythene stent, temporarily
  • Preparation   
  • Avoid aspirin or ibuprofen two weeks before.
  • Fasting for six hours before surgery.
  • Final checks and consultation on the surgery day.
  • Post-Surgery Care   
  • Rest and avoid driving, alcohol, and strenuous activities.
  • Nose bleeding is normal; avoid blowing nose for 7-10 days.
  • Follow-up appointments necessary for stent and suture removal.

Risks and Follow-Up

  • Risks:
  • Bleeding, infection, blockages, tube displacement. Serious risks-rare.
  • External DCR may leave a small scar.
  • Follow-Up:
  • Initial follow-up after 1-2 weeks, further review after six months.
  • High success rate (90-95%), lower in complex cases (70-80%).

Faq

1What Is Epiphora?

Epiphora is the excessive watering of the eyes caused by:

  • Overproduction of tears, or
  • Impaired tear drainage through the tear ducts and drainage channels.

Normally, tears are produced for lubrication and hygiene, then drained into the nasal passages. Any imbalance—especially narrowed or blocked drainage pathways—leads to persistent tearing.

2What are the common symptoms?

Common symptoms include:

  • Persistent watering
  • Itching or irritation
  • Blurred vision
  • Difficulty opening the eyes
  • Light sensitivity
  • Social embarrassment due to constant tearing
3How is it diagnosed?

Diagnosis requires an eye examination focusing on the tear ducts. Techniques include:

  • Fluorescein dye testing to assess drainage speed
  • Tear duct syringing
  • Imaging such as scans or naso-endoscopic examination of inside nose to identify cause of blockage
  • Review of medical history and related conditions
4What causes watery eyes?

1. Excess Tear Production

Triggered by:

  • Allergies
  • Infections (e.g., conjunctivitis)
  • Dry eye syndrome (reflex tearing)

2. Impaired Drainage

Due to:

  • Narrow or blocked tear ducts
  • Congenital obstruction in babies

3. Eyelid Abnormalities

Such as:

  • Ectropion (outward-turning eyelid)
  • Entropion (inward-turning eyelid)
5What are my treatment options?

Non-Surgical Treatments

Used for mild or early-stage epiphora:

  • Antihistamines for allergy-related tearing
  • Warm compresses and lid hygiene for blepharitis
  • Artificial tears for dry eye
  • Tear duct dilation using small probes

Surgical Treatments

Required when non-surgical therapy fails or the drainage system is physically obstructed.

Dacryocystorhinostomy (DCR)- Mr Sira usually performs Endoscopic DCR which is performed internally through the nose using an endoscope.

  • No external scar
  • High success rate (~90%)

Creates a new drainage channel between the tear sac and nasal cavity.

  • May leave a small external scar depending on approach.
  • A temporary internal tube is often placed for 4–6 weeks.

Lester Jones/Stop Loss Tube

A glass tube is inserted into the inner corner of the eye into the nasal passage to bypass a severely damaged or absent drainage system. Used when other surgeries are not viable.

Before the DCR Procedure

Patients are typically advised:

  • Avoid NSAIDs (aspirin, ibuprofen, diclofenac) or anti-platelet medication (clopidigrel) 2 weeks prior to surgery
  • Fast for 6 hours pre-procedure if required (GA)
  • Arrive early for checks
  • Expect general or local anaesthesia depending on the procedure

Aftercare & Recovery

  • Rest immediately after surgery No nose blowing for 1 week
  • No driving for 24 hours
  • Avoid alcohol, sedatives, hot food, and hot drinks on the first day
  • Expect swelling and bruising for several weeks
  • Full recovery: approximately 6 weeks
  • Follow-up within 1–2 weeks
  • Stitch removal if an external incision was used
6What are the risks and side effects of watery eye surgery?

Possible risks include:

  • Bleeding
  • Infection
  • Recurrent blockage requiring further surgery
  • Displacement of the temporary drainage tube (rare)
  • Scarring with external
  • approaches (usually fades over time)
  • CSF leak (extremely rare)
7Is surgical treatment for epiphora painful?
  • Endoscopic DCR: Usually causes minimal discomfort; simple pain relief is typically sufficient.
  • External DCR: Can be more uncomfortable, particularly during the first week.
8Will I have scars after watery eye surgery?
Only external DCR creates a small incision on the side of the nose. These scars typically fade over months and can become barely noticeable with proper care.
9What kind of anaesthesia is used?
Usually general anaesthesia is used, depending on patient preference, medical history, and the surgeon’s recommendation.
10How long does the surgery take?
A DCR procedure generally takes 60–90 minutes.
11How do I know which surgery is right for me?

This depends on:

  • The severity and cause of your tear drainage issue
  • Whether the blockage is partial, complete, or structural
  • Previous treatments and responses

Endoscopic DCR is often preferred due to its lack of visible scarring and high success rate, but other options may be more suitable for complex anatomical issues.

12How long is the recovery period?
Most people recover fully in 4–6 weeks. Swelling and bruising are normal early on.
13Will a tube be placed during surgery?
Most DCR procedures involve placing a small internal silicone tube to maintain the newly created drainage pathway. It is usually removed after 6 weeks.
14Can watery eyes return after treatment?

Yes—recurrence can happen if:

  • Scarring re-blocks the channel
  • The tube becomes displaced during healing
  • Underlying eyelid issues persist