Tearing: Why Your Eyes Water and When It May Be Serious
🧠 Dr. Roque’s Quick Answer
Tearing can happen because your eyes are making too many tears or because tears are not draining normally. Common causes include dry eye, allergies, irritation, eyelid problems, blocked tear ducts, infection, and corneal problems. Mild tearing is often not dangerous, but tearing with pain, redness, light sensitivity, blurred vision, swelling, discharge, or symptoms in a baby deserves an eye check, sometimes urgently.
Tearing sounds simple, but it is actually a symptom with many possible causes. Some people tear because the eye is irritated and reacts by producing reflex tears. Others tear because the drainage system is partially blocked, so even a normal amount of tears has nowhere to go.
Think of the eye like a sink. The eye surface makes tears, spreads them, and then drains them through tiny openings near the inner corners of the eyelids. If the “faucet” is overactive, or if the “drain” is clogged, tears spill over onto the cheeks.
🎯 Focus
Help patients understand why the eyes water and separate minor causes from urgent ones.
🏁 Goal
Make the next step clear: monitor, book an exam, or seek urgent care.
🛡️ Evidence-Based
Tearing can come from surface irritation, inflammation, eyelid malposition, or tear drainage obstruction.
🧠 Dr. Roque’s Key Learning Points
- Tearing does not always mean the eye is “too wet.” Dry eye can also cause watery eyes.
- A blocked drainage pathway can make even normal tear production overflow.
- Redness, pain, light sensitivity, swelling, and blurred vision matter more than tearing alone.
- Babies with constant tearing may have a blocked tear duct and should be examined.
- Sudden tearing after an injury, chemical splash, or contact lens problem should not be ignored.
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👁️ Anatomy Micro-Primer
Your tear system has two main jobs: make tears and drain tears.
- Lacrimal gland: helps produce tears.
- Tear film: coats the eye surface and keeps it smooth and comfortable.
- Puncta: tiny drainage openings near the inner corners of the eyelids.
- Canaliculi, lacrimal sac, and nasolacrimal duct: the drainage channels that carry tears toward the nose.
- Eyelids: spread tears evenly and help pump them into the drainage system.
🧩 Terminology Glossary
- Epiphora: the medical term for tears overflowing onto the face.
- Dry eye: a problem where tears are poor in quality or not balanced well enough to keep the eye surface comfortable.
- Punctum: a small opening on the eyelid where tears enter the drainage system.
- Nasolacrimal duct obstruction: blockage of the tear drainage pathway.
- Blepharitis: inflammation of the eyelid margins.
- Entropion: the eyelid turns inward.
- Ectropion: the eyelid turns outward.
What Does Tearing Actually Mean?
Tearing means tears are spilling out more than usual. That can happen for two broad reasons:
- The eye is producing extra tears. This is often a reaction to irritation, dryness, allergies, or inflammation.
- The tears cannot drain properly. This can happen when the puncta are too narrow, the drainage passages are blocked, or the eyelids are not positioned well.
This is why people are often surprised when an eye doctor says, “Your watery eye may actually be related to dry eye.” Poor-quality tears irritate the surface, and the eye responds by making even more watery reflex tears.
Common Causes of Watery Eyes
1) Dry Eye
Dry eye is one of the most common reasons for tearing. The surface becomes unstable and irritated, and the eye “overreacts” by releasing reflex tears. These extra tears are often watery and do not stay on the eye well enough to solve the underlying problem.
Clues include burning, fluctuating vision, foreign-body sensation, symptoms that worsen with air-conditioning, screen time, wind, or lack of sleep, and tearing that comes and goes.
2) Allergy
Allergies often cause watery, itchy, irritated eyes. Patients may also notice sneezing, nasal symptoms, puffiness, or redness. If itching is a major complaint, allergy moves higher on the list.
3) Blepharitis and Meibomian Gland Dysfunction
When the eyelid margins are inflamed, the tear film becomes unstable. The surface dries and gets irritated, which can trigger reflex tearing. Crusting, eyelid irritation, and fluctuating comfort are common clues.
4) Blocked Tear Drainage
Some patients produce a normal amount of tears, but the tears cannot drain properly. This often causes persistent overflow, especially in one eye. You may notice tears constantly sitting along the lower lid or running down the cheek even when the eye does not feel particularly dry.
5) Eyelid Position Problems
If the eyelid turns inward or outward, tears may not spread or drain normally. Older patients are more likely to develop eyelid laxity, ectropion, or entropion. These problems can also irritate the cornea.
6) Infection
Conjunctivitis, canaliculitis, or infection around the tear sac can cause watering. Infection becomes more likely when tearing is accompanied by discharge, redness, swelling, tenderness, or sticky lashes.
7) Corneal Irritation or Injury
A scratch on the eye, a foreign body, contact lens-related irritation, or a corneal ulcer can cause severe watering. These cases usually also have pain, redness, light sensitivity, or blurred vision.
8) Environmental Irritants
Smoke, wind, dust, perfume, chlorinated water, and screen-related dryness can all trigger tearing. Symptoms may improve when the irritant is removed.
9) Babies with Congenital Tear Duct Blockage
Babies commonly tear because the drainage duct has not fully opened. The eye may look watery or sticky. Many cases improve with time, but persistent symptoms should still be assessed.
💡 Dr. Roque’s Analogy
Imagine rainwater on a roof. If it rains too hard, water overflows. If the gutter is clogged, water also overflows. Watery eyes work the same way. Too much tear production and poor tear drainage can both end in the same result: tears spilling down the face.
When Tearing May Be More Serious
Tearing by itself is often not an emergency. The real issue is whether it comes with other warning signs.
🚨 Dr. Roque’s Emergency Warning
Seek urgent eye care if tearing happens together with any of the following:
- moderate to severe eye pain
- sudden redness that looks significant or deep
- light sensitivity
- blurred vision or reduced vision
- eye injury, scratch, or possible foreign body
- chemical splash
- contact lens pain or redness
- swelling or tenderness near the inner corner of the eyelids
- pus-like discharge
- fever with swelling near the tear sac area
- a baby with constant tearing, discharge, or recurrent eye infection
This is the trap many patients fall into: they assume “it is only watery eyes.” That is not safe thinking. Tearing can be the body’s response to a corneal problem, a blocked duct with infection, or another condition that needs prompt treatment.
Clues That Help Narrow the Cause
How an Eye Doctor Checks Tearing
The correct evaluation depends on the story and the examination. In clinic, I usually want to answer four questions:
- Is the eye surface irritated?
- Is there a problem with the eyelids?
- Is the drainage system open?
- Is there any sign of infection, corneal injury, or another more serious problem?
The exam may include looking at the eyelids, lashes, cornea, tear film, puncta, and tear lake, and checking whether the drainage system appears open. If needed, testing may be done to assess tear drainage or to look more closely for ocular surface disease.
Treatment Depends on the Cause
If the cause is dry eye
- lubricating drops
- better blinking habits during screen use
- managing eyelid inflammation
- adjusting the environment when possible
If the cause is allergy
- allergy control
- cold compresses
- avoiding triggers when possible
If the cause is blepharitis or meibomian gland dysfunction
- eyelid hygiene
- warm compresses when appropriate
- targeted treatment depending on severity
If the cause is blocked tear drainage
Treatment depends on where the blockage is and how severe it is. Some patients need observation. Others may need a procedure to improve drainage.
If the cause is eyelid malposition
Lubrication may help temporarily, but the underlying lid position sometimes needs procedural or surgical correction.
If the cause is infection or corneal disease
These cases need proper diagnosis first. Self-medicating with random eye drops can delay correct treatment and sometimes make the problem worse.
What You Should Avoid
- Do not assume all watery eyes are minor.
- Do not use leftover antibiotic or steroid drops without a proper diagnosis.
- Do not keep wearing contact lenses if the eye is painful, red, or light-sensitive.
- Do not ignore one-sided persistent tearing, especially if it keeps happening.
- Do not delay evaluation if there is swelling near the inner corner of the eye.
When to Book a Consultation
Book an eye consultation if tearing is persistent, recurrent, bothersome, one-sided, associated with discharge, or linked to redness or blurred vision. Even when the cause turns out to be minor, a proper diagnosis saves time and avoids trial-and-error treatment.
✅ Dr. Roque’s Take-Home Message
Tearing is common, but the cause is not always obvious. Your eyes may water because they are irritated, dry, inflamed, poorly draining, or occasionally affected by a more serious problem. The safest move is to pay attention to the whole picture. If tearing comes with pain, redness, light sensitivity, blurred vision, swelling, or discharge, do not dismiss it.
Frequently Asked Questions
Can dry eye really cause watery eyes?
Yes. Dry eye can irritate the surface and trigger reflex tearing, so the eyes may feel dry and watery at the same time.
Is one watery eye more concerning than both eyes watering?
It can be. One-sided persistent tearing raises the question of a drainage problem, eyelid issue, or localized irritation.
When is tearing an emergency?
When it comes with pain, significant redness, light sensitivity, reduced vision, injury, chemical splash, contact lens problems, or swelling near the tear sac area.
Can allergies cause tearing without much redness?
Yes. Some people mainly notice itching and watering, especially during certain seasons or after exposure to triggers.
Why do my eyes water more outside?
Wind, sunlight, temperature changes, and surface irritation can trigger tearing outdoors. Drainage problems may also become more noticeable outside.
Should I use antibiotic drops for watery eyes?
Not unless you have been properly diagnosed. Tearing alone does not prove infection.
Can blocked tear ducts happen in adults?
Yes. Adults can develop narrowing or blockage of the tear drainage pathway.
Is tearing common in babies?
Yes. A blocked tear duct is common in infants, but persistent tearing or recurrent discharge should still be evaluated.
Can screen time make tearing worse?
Yes. Reduced blinking during screen use can destabilize the tear film and trigger reflex tearing.
Will tearing go away on its own?
Sometimes, yes, especially if the trigger is temporary. But persistent, recurrent, or one-sided tearing should not just be watched indefinitely.
📚 Related Reading
📖 References
- American Academy of Ophthalmology. Preferred Practice Pattern resources related to dry eye disease, conjunctivitis, blepharitis, corneal disorders, and lacrimal system disorders.
- StatPearls and major ophthalmic reference texts on epiphora, nasolacrimal duct obstruction, dry eye disease, blepharitis, and eyelid malposition.
- Peer-reviewed reviews on ocular surface disease and reflex tearing.
- Peer-reviewed reviews on adult and pediatric tear drainage obstruction.
- Peer-reviewed reviews on eyelid malposition and tearing.
ROQUE Eye Clinic Patient Education Series
Reviewed by the Roque Advisory Council
Dr. Manolette Roque | Dr. Barbara Roque
St. Luke’s Medical Center Global City | Asian Hospital Medical Center
Philippines
Medical Disclaimer: This page is for patient education only and does not replace an eye examination, diagnosis, or treatment plan. If you have pain, vision loss, light sensitivity, trauma, chemical exposure, or worsening symptoms, seek prompt medical attention.
