what causes watery eyes melbourne

What Causes Watery Eyes and How to Manage It?

A bout of watery eyes affects all of us at some point, whether it’s from chopping onions or because a little bug flew into your eye. However, sometimes watery eyes can suddenly come upon us for no identifiable reason – in these cases, how do you know whether it’s an eye health problem necessitating oculoplastic surgery or something that can just be ignored? Apart from the obvious, what causes watery eyes and how can you manage it? 

 

What Causes Watery Eyes?

The medical term for watery eyes is epiphora. Although unexpectedly teary eyes can be an inconvenience, epiphora is not typically an eye health concern, though it may be bothersome enough for some to seek oculoplastic surgery

Watery eyes are often a reflexive response to something that has caused irritation to the sensitive cornea of the eye. This can be due to chemical irritation, such as cleaning chemical fumes or chopped onions, or physical irritation, like an eyelash in the eye or accidentally brushing against the cornea with your finger. Reflexive tearing is an important reaction as the increased tear production helps to wash away any foreign particles and re-lubricate the surface of the eye. 

Other causes of watery eyes can be due to compromised eye health, such as from eye infections or allergies. If you’ve ever had conjunctivitis, keratitis (inflammation of the cornea), or hayfever, you’ll know that these conditions are among the common reasons of what causes watery eyes. Typically, these causes are easily identifiable as they are associated with other signs and symptoms, such as itching, discharge from the eye, and a red eye. Treating the underlying condition, such as with antibiotic or antihistamine eye drops, will help the epiphora to resolve as the infection or allergy clears.

other what causes watery eyes melbourneAn unexpected cause of watery eyes can be dry eyes. Although counterintuitive, when the surface of the eye is dry, this produces a reflexive reaction to increase tear production from the lacrimal gland. For good eye health and optimal vision, the surface of the eye needs to stay well lubricated with a stable layer of tears. Dry eyes occur when this tear film is thinned or uneven, or simply evaporates too rapidly between blinks. Though it may seem unusual to be adding more moisture into an already watery eye, treating the dry eye condition with lubricant eye drops can often help to remove the stimulation for the eye to produce reflexive tears. Other dry eye therapies such as warm compresses or intense pulsed light treatment can also help if dryness is the underlying cause of the tearing. 

Along with dry eyes, changes to the nasolacrimal system and eyelids can be the most difficult to identify as an underlying reason for what causes watery eyes. The nasolacrimal system and eyelids play a big part in draining away tears from the surface of the eye. With each blink, a properly functioning pair of eyelids pushes tears pooling along the margin of the bottom eyelid towards two tiny openings at the inner corners of each eye, known as puncta. Assuming the nasolacrimal system is open and unobstructed, tears can then drain through these apertures, down the nasolacrimal duct and eventually down the back of the throat. However, age, trauma, and disease can affect the effectiveness of the eyelids and nasolacrimal system at draining away tears, resulting in epiphora. Oculoplastic surgery may be the only effective treatment for such causes of watery eyes. 

 

Oculoplastic Surgery for Watery Eyes

Oculoplastics refers to a subspeciality of ophthalmology focused on the structures around the eyes, including the eyelids, eye socket, nasolacrimal system, and nearby facial anatomy. An oculoplastics eye surgeon can address epiphora via a number of surgical and non-surgical methods, depending on the underlying cause.

Obstruction or narrowing of the puncta is not uncommon with age, impeding the passage of tears through these apertures. In some minor cases, stretching these openings in a non-surgical procedure known as punctal dilation may be sufficient, however, if the puncta are quite narrow or quickly revert back to their narrowed state, the insertion of a stent or a small operation called punctoplasty may be necessary to widen the puncta. If there is narrowing of the lacrimal ducts beyond the puncta, a dacryocystorhinostomy is a procedure used to create a new drainage channel between the eye and the nose. 

A blocked nasolacrimal system can also be caused by an abnormal growth, either cancerous or benign. As part of an investigation into epiphora, the eye surgeon will be able to determine if this is the case and operate appropriately if necessary.  

Various dysfunctions of the eyelids may contribute to poor drainage of tears and resultant watery eyes. This includes the lower eyelid becoming loose with age and flopping away from the eye (ectropion) or a weak blink, such as from Bell’s palsy and facial nerve paralysis. Treatment by an oculoplastics specialist may include an ectropion repair, tightening the lower eyelid such that it sits against the eye properly, or the insertion of small gold weights into the upper eyelid to help it close fully with each blink. If there are any bumps along the lower eyelid margin that may be disrupting the flow of tears, these can be surgically removed. 

 

 

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

signs of retinal detachment melbourne

Signs of Retinal Detachment – Recognising the Condition

A retinal detachment is considered an ocular emergency requiring prompt treatment to save your sight. Although a retinal detachment is painless, without attention from an ophthalmologist experienced in retinal surgery, the vision loss can be permanent and significant. Knowing the symptoms and signs of a retinal detachment can enable you to seek help quickly. 

 

What is a Retinal Detachment? 

The retina is the layer of sensory tissue lining the back of the eye. It’s the cells of the retina that receive the incoming light from the world around us, convert it to neural signals, and transmit these signals via the visual pathways to the necessary processing centres of the brain for vision. 

For the retina to function properly (and for vision to work), it needs to be able to access the basic necessities – a blood and oxygen supply, plus a metabolic waste removal system. The retina must also, of course, be physically able to send along its neural signals via a connected network of cells. A retinal detachment occurs when the retina is separated from its underlying layers, removing its access to the support it needs to function. Many eye care practitioners will describe a retinal detachment as like wallpaper peeling away from the wall. This results in a loss of sight in the area of the detached retina. A retinal detachment may occur just in one area of the retina, or in severe cases, the entire retina may come away, resulting in complete blindness in that eye. 

Eyecare professionals will often refer to a retinal detachment case as “macula on” or “macula off”. The macula is an anatomical part of the retina responsible for your central vision. The status of the macula – whether it is detached or still attached – can determine how urgently retinal surgery needs to be performed. As the central vision is still intact in a macula-on retinal detachment, ophthalmologists will recommend prompt treatment, typically within 24 hours, in order to preserve the vision. However, in a macula-off detachment, as the prognosis is immediately much poorer for recovering the central vision, immediate retinal surgery is less critical. Nonetheless, treatment for a macula-off detachment is still recommended within 7-10 days for the best possible visual recovery. 

While some retinal detachments occur for no identifiable reason, a situation known as an idiopathic retinal detachment, there are some known factors that can increase your risk. These include:factors signs of retinal detachment melbourne

  • A history of trauma to the eye
  • A history of a previous retinal detachment
  • A family history of retinal detachment
  • Any degree of myopia (short-sightedness), with the risk of retinal detachment increasing as the degree of myopia increases
  • Older age
  • Certain eye operations, such as cataract surgery
  • Other eye conditions, such as a retinal hole or tear, diabetic retinopathy, or lattice degeneration 

 

What are the Signs of a Retinal Detachment?

Signs of a retinal detachment include:

  • The sudden appearance of small floating specks within the eye, known as floaters. Typically, this presents as a shower of many tiny dark drifting flecks or sometimes as cobwebs or drifting lines or squiggles in the eye. Floaters from a retinal detachment are due to fragments of retinal tissue or drops of blood from broken retinal capillaries floating inside the eye. 
  • The sense of flashing lights in the vision. This phenomenon is known as photopsia and is a result of the mechanical stimulation of the retina as it pulls away, giving the sensation of light perception.
  • A sudden darkening or loss of vision in one area of the eye. Some will describe this sensation as like a dark curtain coming across the vision. This dark shadow occurs in the area of the detached retina as it loses its ability to detect light. 

Another eye condition known as a posterior vitreous detachment can often present with signs similar to a retinal detachment.  A posterior vitreous detachment is a normal age-related change to the vitreous gel inside the eye that can also cause floaters and photopsia. While most cases of flashing lights and floaters are likely to be a posterior vitreous detachment, as these may also be a sign of a retinal detachment it is important not to simply dismiss these symptoms but still get checked by an optometrist or ophthalmologist. A posterior vitreous detachment can increase the risk of a retinal detachment by causing a hole or a tear during the process of the vitreous gel liquefying. 

 

Treatment

A retinal detachment can be treated a few different ways, often depending on the location and size of the detachment. An ophthalmologist experienced in retinal surgery will counsel you on the most appropriate treatment, which may be:

  • Pneumatic retinopexy: the injection of a silicon gas bubble into the eye, which pushes the detached retina back into position.
  • Vitrectomy: surgical removal of the vitreous gel, so that it no longer pulls on the retina.
  • Scleral buckle: a band of silicon is sutured to the outside of the eyeball, which indents the wall of the eye inwards to encourage the retinal to reattach. 

 

As a retinal detachment can have devastating consequences on vision, it’s important never to ignore your symptoms. 

 

 

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.