When patients suffer from tearing, it is caused either by overproduction of tears, or inadequate drainage. In the case of overproduction, dry or irritated eyes signal increased production of tears from the lacrimal gland – more than what your drainage system can handle. Often, simple changes such as increased artificial tear use or allergy drops can solve this problem. Other times, a surgical approach to fixing the ocular irritant, such as eyelid laxity or eyelid malposition, is required to alleviate the tearing.
In the case of inadequate tear drainage, there is a blockage somewhere within the lacrimal drainage system (puncta, canaliculi and nasolacrimal duct). This can be caused by punctal or canalicular stenosis, stones within the canaliculi (caused by chronic infection), retained punctal plugs within the canaliculi, infection in the sac (dacryocystitis), or nasolacrimal duct obstruction (caused by chronic inflammation that may be related to environmental exposure, nasal inflammation or chronic sinus disease). All of these conditions require surgical repair, often with placement of temporary “stents” that stay in place for a number of months following surgery and can be removed safely and comfortably in clinic.