Tears drain the eyes through a channel called the lacrimal punctum into the lacrimal sac and further into the nasolacrimal duct. One can experience teary/watery eyes due to 4 main causes:

1. Blocked punctum – If the Punctum is blocked or has stenosis (narrowing), there will be decrease in drainage of tears, which would cause the tears to overflow
2. Dry Eye Syndrome – Inconsistent/insufficient oil layer on the front surface of the eye can cause eyes to excessively water/tear. Lack of oil layer causes dryness of the front surface of the eye, which overstimulates lacrimal gland’s production of watery tears.
3. Consistent irritation with an allergen – Work/home environment can have pollutants/irritants (example – dust, mold etc) that irritate the front surface of the eye causing it to tear.
4. Eyelid abnormality – Ectropion (eyelid turned out), entropion (eyelid turned in) and irritation to the front surface of the eye by eyelashes can cause the eyes to tear excessively.

Infants can sometimes experience teary eye. This symptom is most commonly due to obstruction at the end of nasolacrimal duct (valve of Hesner). As the tears stay stagnant in the nasolacrimal duct, potential for infections also remains. Most cases resolve with hydrostatic/lacrimal massage but some require minor surgical interventions.

It is strongly advised to get any of the eye symptoms evaluated by your eye care physician. Symptoms can overlap and hence it is important to diagnose the underlying cause.

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