Watery eyes can be a sign of conjunctivitis, which is a common conditions characterized by eye swelling that is caused by viruses, bacteria or other allergens. Watery eyes can also occur with a cold or flu, and can usually be resolved with saline solutions or antihistaminic eye drops.
However, tearing of the eye can also be a sign of a corneal ulcer, ocular herpes or blockage of the tear duct, for example, which are conditions that should be evaluated by a doctor so that the most appropriate treatment can be initiated.
If you experience other symptoms in addition to watery eyes, such as redness, blurred vision, itching, a feeling of sand in the eye, heavy eyelids and swelling in the eyelid, it should seek further medical attention.
What causes watery eyes?
The most common causes of watery eyes include:
1. Pink eye
Pink eye, or conjunctivitis, is an inflammation of the eye that can occur due allergies, coming in contact with an irritating substance or a bacterial or viral infection. With conjunctivitis, you may also experience redness, itching, clear discharge or crust and irritation.
What to do: The treatment of conjunctivitis depends on the underlying cause of it. If it is triggered by an allergy, anti-histamine eye drops and cleansing the eye with saline water can help soothe irritation. Eye infections require antibiotic eye drops for treatment. The doctor may additionally prescribe anti-inflammatory eye drops to help with swelling. Read more about how to clean eye discharge in newborns who may have conjunctivitis.
2. Cold or flu virus
During a cold or flu, some people may report watery eyes, as well as coughing, fever, sore throat, headache, runny nose and fatigue. These symptoms are more intense with the flu and usually last for longer. Learn more about the difference between a cold and a flu and how they present.
What to do: Treatment for the cold and flu consists of managing upper respiratory symptoms and pain. You can use analgesics and anti-pyretics, like acetaminophen, anti-histamines, like loratadine, and anti-inflammatories, like ibuprofen to help relieve symptoms. In addition, you can boost your immune response by taking vitamin C, as prescribed by your doctor. Learn more about home remedies for the cold and flu that you can use to complement your medical treatment.
3. Corneal ulcer
A corneal ulcer is an inflamed wound that occurs on the cornea in your eye. It is associated with symptoms like pain, the sensation that something is stuck in your eye, and blurred vision. Normally, it is caused by an eye infection, but it can also be a result of a small cut to the eye, dry eyes, contact with irritating substances or immune system diseases, like rheumatoid arthritis or lupus.
Some people are more at risk for developing corneal ulcers, like those who use contact lenses or steroidal eye drops, and those who have corneal wounds or burns.
What to do: Treatment should be initiated urgently to prevent further damage to the cornea. Infections are typically treated with the administration of antibiotic, anti-fungal and/or anti-inflammatory eye drops. Corneal ulcers that are a result of other systemic conditions may resolve when the condition is appropriately treated or managed.
4. Allergies
Respiratory allergies can emerge when the airways come in contact with irritating allergens, like pollen, dust, mould, fur, or other substances. They are associated with symptoms like a stuffy or runny nose, constant sneezing, dry cough, redness, watery eyes and headaches.
What to do: Treatment consists of the use of anti-histamines, like loratadine or cetirizine. Allergies that cause difficulty breathing may also be treated with bronchodilators like salbutamol or fenoterol.
5. Cluster headaches
A cluster headache is a headache that appears usually on one side of the face or head. This headache is usually very intense, throbbing and emerges during sleep. Although they are more rare, cluster headaches are stronger and more incapacitating than a migraine, and they are often described as the worst pain ever felt - worse than kidney stones, pancreatitis or labor pain. Other symptoms associated with cluster headaches include redness, watery eyes on the side affected, eyelid swelling and a runny nose.
Learn more about the different types of headaches and how treatment differs from each one.
What to do: This illness does not have a cure, however symptoms can be managed with non-steroidal anti-inflammatories, opioids and a 100% oxygen mask.
6. Sinusitis
Sinusitis is a condition that occurs when the lining of the nasal cavities becomes swollen. Sinusitis can be triggered by irritating substances in the air, fungal infections and allergies.
The most common symptoms of sinusitis are facial pain, nasal discharge, watery eyes and headaches, although symptoms can vary depending on the cause of swelling. Read more about the symptoms of a sinus infection.
What to do: Treatment for sinusitis depends on what induced it, but generally it involves the use anti-inflammatories, corticosteroids, antibiotics and nasal decongestants. See other ways you can treat sinusitis naturally at home.
7. Blepharitis
Blepharitis is inflammation of the eyelid caused by changes in the Meibomius glands. These glands are present in the eyelids and are responsible for maintaining moisture in the eye. Abnormalities can cause excessive tearing, in addition to the appearance of crusts around the eye, itching, redness in the eye, and swelling of the eyelids.
What to do: Treatment for blepharitis can be done at home by regularly cleansing the eyes, as this can restore eye moisture and stimulate the normal function of the glands. Be sure to keep the eye clean and remove any secretions and crust. You can also apply a warm compress to the eye for about three minutes 3 times a day to alleviate symptoms.
However, when inflammation of the eyelids recurs, it is important that see an ophthalmologist so that the cause of the blepharitis can be investigated and more specific information can be initiated.
8. Meibomitis
Meibomitis is the inflammation of the meibomian glands located in the upper and lower eyelids of the eyes. Swelling can lead to watery eyes, tears with a foamy appearance, redness or swelling of the eyelids.
This inflammation can arise due to the use of contact lenses, exposure to dry environments, excessive computer or cell phone use, hormonal changes, or even from using eye drops to treat glaucoma.
What to do: Treatment for meibomitis should be carried out as directed by an ophthalmologist. Treatment depends on the severity of symptoms, any may involve the application of warm compresses to the eyelids, using lubricating eye drops, using corticosteroids or antibiotics, or in more serious cases, surgery.
9. Eye herpes
Ocular herpes is an infection of the eye caused by the herpes simplex virus type 1. It can affect one or both eyes and lead to the appearance of symptoms similar to pink eye, such as excessive tearing, eye dryness, itching, swelling, redness, and eye irritation, and blurred vision. In addition, this virus causes fluid-filled blisters or ulcers near the eye that are red and painful.
Ocular herpes is contagious and can be easily transmitted from person to person through contact with blisters, wither directly or indirectly. It can also be transmitted from other areas of the body (e.g. the lips).
What to do: You should consult an ophthalmologist as soon as possible to start treatment and prevent complications such as blindness. Generally, the doctor will prescribe ophthalmic ointments or antiviral eye drops, as well as corticosteroids, oral antivirals or antibiotics.
10. Migraines
A migraine is a type of intense, pulsing headache that can cause throbbing pain behind the eyes. It can be accompanied by other symptoms such as tearing, sensitivity to light, the presence of spots in the field of vision, or even dizziness, nausea or runny nose, for example. Read more about the symptoms of migraines and who is most at-risk for them.
Migraines can be triggered by hormonal changes, stress, strong smells, flickering lights or even food allergies.
What to do: It is important to rest and stay in an environment with reduced noise and light, as this will help alleviate the migraine. Furthermore, if migraines are frequent, you are advised to consult a neurologist to identify the cause of the migraine and, if necessary, start treatment with medication.
11. Clogged tear duct
A clogged tear duct is a total or partial blockage of the gland that produces tears. It causes symptoms such as excessive tearing, redness, pain or swelling in the inner corner of the eye.
A clogged tear duct, also know as dacryostenosis, can occur in babies from birth, due to malformation of the tear duct or abnormal development of the face, but it can also develop at any age. In adults, it is often the result of an infection or direct blows to the nose.
What to do: Clogged tear ducts in newborns usually improve by 1 year of age, and specific treatment is not usually needed. The pediatrician may recommend cleansing of the eyes with saline solution, to maintain eye lubrication and prevent dryness, as well as circular massages near the inner corner of the affected with the finger pad.
Clogged tear duct caused by infections or fractures in the nose region should be assessed by an ophthalmologist who can recommend the most appropriate treatment, such as the use of anti-inflammatory eye drops or antibiotics. In more serious cases, a small surgical procedure may be necessary to unblock the tear duct.
12. COVID-19
COVID-19 is primarily a respiratory disease and is most commonly associated with symptoms like a persistent dry cough, fever and loss of taste and smell. However, it can also cause eye symptoms, like optic neuritis, pink eye, keratoconjunctivitis or hemorrhagic conjunctivitis. Associated symptoms include watery eyes, as well as eye pain, sensitivity to light and itchy eyes.
The changes in the eyes caused by COVID-19 are not yet fully understood, but they appear to occur due to the worsening of a pre-existing disease in the eyes. It can also be caused by direct damage by the virus to the nerves, blood vessels or other structures in the eyes.
What to do: In this case, it is important for patients to remain in isolation and consult a doctor. Positive cases are treated with plenty of rest and the use of medications that help alleviate symptoms.
13. Chemotherapy
Some medicines used in chemotherapy for the treatment of cancer, mainly cyclophosphamide, can cause watery eyes, especially during when the medication is being administered. Other common symptoms include a runny or blocked nose or sneezing.
Furthermore, most drugs used in chemotherapy can increase the risk of infections, which can appear in any part of the body, including the eyes. They can also cause changes to tear composition and increase the risk for pink eye, ulcers in the cornea, blepharitis or keratitis.
What to do: if you experience tearing during a cyclophosphamide infusion, you should immediately notify the nurse, who can reduce the speed at which the medicine is administered to relieve watery eyes.
Furthermore, to avoid eye infections caused by chemotherapy, you should keep your eyes clean, avoid touching your eyes with dirty hands or use artificial tears recommended by your ophthalmologist to maintain eye lubrication. If an infection occurs, the ophthalmologist may recommend the use of eye drops with antibiotics or corticosteroids.