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.

how to get rid of a chalazion melbourne

How to Get Rid of a Chalazion? What Is It and What You Can Do About It?

Chalazion is not a word you hear very often, despite being a reasonably common eyelid bump. Many people in fact don’t realise they have a chalazion on the eyelid, instead believing that painless lump is called a stye. In fact, the two are technically different conditions, although there are some similarities in how to get rid of a chalazion to how you get rid of a stye. Fortunately, both tend to be managed successfully with conservative home remedies without requiring referral to an oculoplastic surgery specialist


The Difference Between a Chalazion and a Stye

Before understanding how to get rid of a chalazion, it’s important to understand how it differs from a stye. A stye is also known as a hordeolum, and is an active infection of one of the glands of the eyelid, typically by the staphylococcus family of bacteria. On the other hand, a chalazion is non-infective, and is instead caused by a blockage of the sebaceous oil glands within the eyelid that contribute to the tear film of the eye, known as the meibomian glands. The meibomian glands line both the upper and bottom eyelids, and secrete their oils called meibum, onto the surface of the eye from tiny orifices along the eyelid margin just behind the eyelashes. 

When a meibomian gland becomes obstructed, meibum accumulates behind this blockage, causing a swollen lump that we then identify as a chalazion in the eyelid. Initially, this lump may be a little tender to touch and slightly red, but within a few days resolves to a painless, firm bump on the eyelid that can persist for weeks. Conversely, a stye typically presents as a yellowish or whitish pimple-like bump next to an eyelash, associated with pain and inflammation for a few days before it naturally ruptures and drains its contents. One of the most important differentiating factors to remember between a chalazion and a stye is that a chalazion does not involve any active infection whereas a stye does. 


How to Get Rid of a Chalazion?

factors how to get rid of a chalazion melbourneReferral for oculoplastic surgery is rarely warranted for chalazia (the plural of chalazion), and is only required for very large or persistent bumps. Initially, your eyecare provider or GP will most likely suggest conservative therapy in the form of a simple hot compress over the affected eyelid, as the heat will help to speed up the body’s natural process of resolving the chalazion by reducing the blockage obstructing the meibomian gland and clearing away the accumulated waste material. There are no prescribed guidelines for how long or how often you should apply the warm compress – anywhere from 2 to 5 times a day, 5 to 10 minutes at a time can be appropriate. It is important that you never try to pop or squeeze the bump as doing so may spark an inflammatory reaction as the contents of the chalazion are spread through the soft tissues through force.

If you break the skin while trying to pop the chalazion, you may also risk causing yourself a bacterial infection. Even without using a hot compress, a chalazion will self-resolve eventually, typically within a few weeks to a couple of months.

Because a chalazion is not an active infection, antibiotics are ineffective and should not be taken. If your eyelid bump is diagnosed as a stye, topical or oral antibiotics may be recommended as there is an actual bacterial infection that can respond to antibiotic treatment; this being said, many styes will self-resolve within a few days without intervention. 

In some cases, your optometrist or GP may recommend you see an ophthalmologist experienced in oculoplastic surgery. Such situations may involve chalazia that are very large, causing issues with appearance that the patient finds distressing, or chalazia that are located centrally along the eyelid and are large enough to press on the eyeball, causing distortion of the cornea. The cornea is the transparent dome of tissue at the very front surface of the eye and if even slightly distorted from the pressure of the chalazion, can cause temporary blurred vision in that eye.

Occasionally, chalazia can also take a very long time to self-resolve, sometimes lasting for several months. Although it is safe to simply ignore it and allow it to heal slowly by itself, some people may prefer instead to undergo oculoplastic surgery for an immediate resolution. This is typically in the form of a procedure known as incision and curettage, which involves making a small cut into the eyelid under local anaesthesia and scooping out the contents of the blocked gland. Another option the eye specialist may recommend is the injection of a steroid into the chalazion to reduce its size and speed up resolution. 

Chalazia can recur, particularly if you have an underlying condition that causes you to be more prone to encountering them in the first place. Skin and eye conditions that affect the function of the meibomian glands such as acne rosacea or meibomian gland dysfunction can increase your risk of experiencing recurrent chalazia (and styes). Keeping these underlying conditions under control can reduce your risk of recurrent chalazia. Occasionally, a frequently reoccurring chalazion, particularly one that always pops up in the same place on the eyelid, may be indicative of a more serious disease, such as skin cancer. If your eye specialist suspects this, he or she will perform a biopsy on the bump to rule out any malignancy. 



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