Dear Doctor Column, September 3, 2001

Question:

Can you discuss cause and treatment of excessive eye secretion? I have secretion which sometimes is thicker with more mucus than regular tears. Could it be an occluded tear duct and, if so, what is the treatment?

Answer:

Watery eyes - also called excessive tearing or epiphora -may very well be caused by excessive tear production or by improper drainage of the tear ducts, due to a blockage in the tear drainage system. However, without a complete eye examination and medical history, we can only speculate about the cause of your excessive mucoid eye secretion.

For example, are you experiencing the problem in one eye or both eyes? Is it associated with pain, irritation, redness, or itching? If so, where and when? Pain at the side of nose suggests an infection in the lacrimal ducts that drain the tears. Pain in the eye itself suggests foreign material is in the eye or inflammation of the eye. Itchiness suggests an allergy. Do you wear contact lenses? Have you had eye or eyelid surgery? These are just a few of the questions your eye doctor would ask in an effort to pinpoint a possible cause of the problem.

Tears keep the surface of the eyes moist, wash away small particles that get onto the eye surface, and contain antibodies that help prevent infection. The lacrimal gland is a specialized gland located under the outer one-third of the upper eyelid that makes tears. Normally the gland produces about 2 teaspoons full of tears a day. Each time you blink, the eyelid spreads the tears over the surface of the eye and pumps excess tears into a "duct" that drains the tears into your nose. That is why your nose runs when you cry.

The production of excessive tears can be caused by a foreign object in your eye (such as sawdust, an eyelash, or a speck of dust), something in the air (such as smoke or smog), an allergy (to pollen, ragweed, dust or pet dander, for instance), an eye infection, or dry eye syndrome.

Blockages in the tear drainage system can occur as a result of scarring, due to an eye or nose injury or to chronic sinus infections, as well as to aging and infection. Canaliculitis refers to an infection of the lacrimal drainage system that is sometimes painless. However, the infection can cause pain, itching, and localized swelling of the eyelid. Often, a mucus discharge appears. Canaliculitis is more common in postmenopausal women and here is ascribed to hormonal changes that may decrease tear production and predispose to infection. Infection can sometimes lead to stones in the duct.

We suggest you make an appointment with your eye doctor to diagnose the cause of your excessive mucoid eye secretion. Your treatment will depend on what the eye doctor finds. If a tear duct blockage is present, the doctor may be able to flush the blockage and treat any infection that is present. If the tearing causes severe symptoms, surgery can be performed to create a new tear duct. This operation is called dacryocystorhinostomy.