SYMPTOMS OF TEARING
Unfortunately, the majority of patients suffering or teary eyes are still being misdiagnosed as having conjunctivitis or dry eyes and it takes sometimes years before the correct diagnosis is made. Even though both dry eyes and conjunctivitis can be responsible for a certain type of watery eyes (reflex tearing), lacrimal obstruction is often present in the majority of cases as the primary cause. In fact, most patients complaining of watery eyes have a combination of causes that all need to be taken into account, otherwise the result of treatment is suboptimal or incomplete.
Sometimes, the distinction between overproduction and insufficient drainage of tears can be done based on patient’s symptoms.
TRACK YOUR SYMPTOMS
Tearing occurring mostly when watching TV, working on the computer, phone, tablet or when driving is likely to be secondary to dry eyes and irritation, which leads to an overproduction of tears. Any history of eyelid problems (eyelids turned in or out, eyelashes rubbing on the eyeball or facial palsy) is suggestive of a combined mechanism (reflex tearing and functional stenosis). In the majority of these cases, the eyes feel more dry than wet and the tearing is intermittent (on and off).
In contrast, constant tearing with copious mucus discharge that accumulates in the inner corner of the eye in the morning is suggestive of a tear duct obstruction. Any history of chronic sinusitis, allergies, nasal surgery or trauma is also suggestive of nasolacrimal duct obstruction.
It is very important to understand that most patients present with a combination of these signs and symptoms because the cause of tearing is complex and both over-productive and obstructive mechanisms are frequently encountered in the same patient.