By Alon Kahana, MD, PhD (University of Michigan)

Excessive tearing, also known as “epiphora,” is a very common condition that can truly affect patients adversely. While tearing might seem fairly trivial, tears welling up on your eyes can blur vision, interfere with driving, create socially awkward situations, and flow down the cheeks onto books or magazines. The constant dabbing that patients often engage in can also lead to skin irritation, while the chronic wet skin can lead to fungal infections.

Tearing can be caused either by excessive tear production, or alternatively by poor outflow of tears through the tear drainage system. A little known fact is that tears, once they wash over our eyes, are actively collected by plumbing and pumping system and pushed into the nose and pharynx (where they get swallowed). That’s why our nose runs when we cry, and why our throat gets irritated when we have eye allergies.

Treatment of epiphora needs to address the underlying cause of the tearing. Are you tearing because your eyes are actually excessively dry and the body tries to compensate by producing more tears? Or is your nasolacrimal duct blocked because of inflammation and chronic accumulation of debris, or as a result of chronic sinusitis?