Epiphora or Lacrimation: Causes, Symptoms, Diagnosis and Treatment

Medical definition:

Epiphora or tearing is a condition in which there is an overflow of tears on the face, often without a clear explanation.

There is not enough drainage of the tear film of the eye or eyes. Instead of tears running through the nasolacrimal system, they overflow into the face.

Tears are necessary to keep the eye’s front surface healthy and maintain a clear vision, but too many tears can make sight difficult. This can make driving, for example, difficult or dangerous.

The epiphora can develop at any age, but it is more common in people younger than 12 months or older than 60 years. It can affect one or both eyes.

Lachrymatory eyes can usually be treated effectively.


The two leading causes of epiphora are blocked tear ducts and excessive tear production.


Some people are born with underdeveloped tear ducts. Newborns often have watery eyes that disappear within a few weeks as the ducts develop.

The most common cause of epiphora among adults and older children is obstruction of the too narrow ducts. The narrowed tear ducts usually become the result of swelling or inflammation.

Tears can not drain and accumulate in the lacrimal sac if the tear ducts become narrowed or blocked.

Tears stagnant in the lacrimal sac increase the risk of infection, and the eye will produce a sticky fluid, making the problem worse. The disease can also cause inflammation in the side of the nose, near the eye.

Narrow drainage channels inside the eyes (canaliculi) can be blocked, caused by swelling or scarring.

Overproduction of tears

Irritated eyes can produce more tears as the body rinses the irritant.

The following irritants can cause the overproduction of tears:

  • Some chemicals, and even onions.
  • Infectious conjunctivitis.
  • Allergic conjunctivitis.
  • An injury to the eye, such as a scratch or a bit of sand.
  • Trichiasis, where the eyelashes grow inward.
  • Ectropion is when the lower eyelid turns outwards.

Some people have tears that are high in fat or lipids. This can interfere with the uniform spread of fluid through the eye, leaving dry spots that become irritated and causing the eye to produce more tears.

Other causes

There are many causes of excessive tearing. The following conditions, among others, can also lead to an overflow of tears:

  • Keratitis is an infection of the cornea.
  • A corneal ulcer is an open sore that forms in the eye.
  • Styes or chalazion lumps can grow on the edge of the eyelid.
  • Bell’s palsy
  • Dry eyes.
  • Allergies, including hay fever.
  • A problem with glands in the eyelids is called Meibomian glands.
  • Use of certain medications

Symptoms of Epiphora

If the following symptoms occur, the person should see a doctor:

  • Reduced vision
  • Pain or swelling around the eyes
  • A feeling that something is in the eye.
  • Persistent redness in the eye.


The treatment depends on how severe the problem is and the cause. In mild cases, doctors may recommend simply waiting closely or doing nothing and monitoring the patient’s progress.

The different causes of epiphora have specific treatment options:

  • Irritation: If the epiphora is caused by infectious conjunctivitis, the doctor may prefer to wait a week to see if the problem resolves only without antibiotics.
  • Trichiasis: A tab that grows inward or some foreign object lodged in the eye; the doctor will remove it.
  • Ectropion: The eyelid turns outward; The patient may have to undergo surgery in which the tendon that holds the outer eyelid in place is tensed.
  • Obstructed tear duct: Surgery can create a new channel from the lacrimal sac to the inside of the nose. This allows tears to avoid the blocked part of the tear duct. This surgical procedure is called dacryocystorhinostomy.

If the drainage channels, or canaliculi, inside the eye narrow but do not entirely block, the doctor can use a probe to widen them. When the canaliculi are wholly blocked, an operation may be required.

Epiphora in babies

In newborns, the condition usually resolves in a few weeks. Sometimes, a sticky liquid may form around the baby’s eye or eyes.

You can use a piece of cotton that has been soaked in sterile water to clean the eyes; the pure water should be boiled, but make sure it cools before you dip the cotton in it.

Sometimes, tears can be released by gently massaging the tear ducts. Apply light pressure with your finger and thumb towards the outside of the nose.

Home remedies

Some cases of epiphora can be treated without consulting a doctor.

Here are some suggestions:

  • Take a break from reading, watching television, or using the computer.
  • Lubricate the eyes with eye drops without a prescription.
  • Hold a warm, moist cloth over your eyes and massage your eyelids to release any obstructions.

Diagnosis of Epiphora

The epiphora is relatively easy to diagnose; the doctor will try to determine if it has been caused by injury, infection, entropion (eyelid that turns inwards), or ectropion (eyelid that turns outwards).

In some cases, the patient may be referred to a doctor specializing in eye care, or an ophthalmologist, who will examine the eyes, possibly under anesthesia.

A probe can be inserted into the narrow drainage channels inside the eye to see if they are blocked. Fluid can be inserted into a tear duct to see if it comes out of the patient’s nose.

If it is discovered that it is blocked, a dye can be injected to find the exact location of the blockage; This will be done by using an X-ray image of the area. The paint appears on the x-ray.