Tearing is a very common problem in the population, and although it is not serious, it is very annoying. Apart from the discomfort of having to dry your eyes with a handkerchief, which can hinder many social activities, continuous tearing often causes irritation of the skin where the tears fall, generally caused by continuous drying. It can also partially impair vision, since normal vision requires a homogeneous tear. When there is an excess of tears in the eye, there is an alteration in vision, which is usually very variable, and typically affects reading more.

Tearing is an annoying and very common problem that almost always has a solution, which is why it is very important to have it assessed by a specialist who can offer the most appropriate solution.

Why can the eye cry?

The production and elimination of tears in the eye is similar to a sink. The eye may cry because of excess tear production (too much water coming out of the tap) or because the tear that is produced is not eliminated properly (having some alteration that makes it difficult for the water to reach the pipes or blocked pipes).

Excess production can be due to anything that irritates the eye (irritative tearing) such as something getting into the eye, conjunctivitis or dry eye in its initial stages, in which the basal tearing at rest is not sufficient and triggers an ineffective reflex tearing that makes the eye water. Treatment consists of removing the cause of the irritation and, if this is not possible, moisturising the eye well with artificial tears to try to reduce the reflex tearing.

It can be mainly attributed to three major mechanisms:

  1. Impaired entry of tears into the lacrimal duct (the drainage system): This can result from the displacement of the lacrimal punctum (the entry point) from its normal position, as seen in ectropion, or its partial or complete closure or blockage, as in lacrimal punctum stenosis. The treatment involves repositioning the lacrimal punctum to its original location and ensuring an appropriate size.
  2. Altered blinking mechanism: Blinking serves as a mechanism that propels tears into the lacrimal duct (acting like a pump that sucks in tears). This mechanism may be disrupted in conditions such as facial paralysis or due to excessively lax eyelids that compromise the effectiveness of this pumping mechanism. Treatment typically involves tightening the eyelids to restore strength to the pumping mechanism.
  3. Closure of the lacrimal duct (the drainage system): The lacrimal ducts can be partially or completely closed. The treatment often involves creating a new connection between the lacrimal duct and the nose to restore proper drainage.

The causes of lacrimation are different in children and adults, and their treatment is therefore also different. In children, the most common cause is congenital (from birth) obstruction of the tear duct. Treatment, when necessary, is usually by catheterisation.


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