Eye

Dry Eyes Watering: Understanding Punctal Plugs and Effective Treatments

by alexxlab

How do punctal plugs work for dry eye syndrome. What are the causes and symptoms of dry eyes. Can dry eyes cause excessive tearing. What are the most effective treatments for chronic dry eye.

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The Paradox of Dry Eyes and Excessive Tearing

Dry eye syndrome is a common yet often misunderstood condition that affects millions of people worldwide. One of the most perplexing aspects of this condition is that it can sometimes lead to excessive tearing, seemingly contradicting its name. This phenomenon often leaves patients confused and frustrated, wondering how their eyes can be both dry and watery at the same time.

The explanation lies in the complex mechanism of tear production and drainage. When the eyes become excessively dry and irritated, the tear glands may respond by producing a large volume of tears in an attempt to alleviate the discomfort. However, these reflex tears are often of poor quality and evaporate quickly, failing to provide lasting relief.

Common Triggers for Excessive Tearing in Dry Eye Patients

  • Prolonged reading or screen time
  • Exposure to cold or windy conditions
  • Bright lights or glare
  • Certain medications
  • Hormonal changes

Understanding this paradox is crucial for both patients and healthcare providers in order to accurately diagnose and treat dry eye syndrome effectively.

Understanding Punctal Plugs: A Novel Approach to Dry Eye Treatment

Among the various treatment options available for dry eye syndrome, punctal plugs have emerged as an innovative and effective solution. But what exactly are punctal plugs, and how do they work?

Punctal plugs are tiny, biocompatible devices inserted into the tear ducts to block the drainage of tears from the eye’s surface. By preventing tears from draining too quickly, these plugs help maintain a higher volume of natural tears on the eye, providing relief from dryness and associated symptoms.

Types of Punctal Plugs

  1. Temporary plugs: Made from dissolvable materials like collagen
  2. Semi-permanent plugs: Usually made of silicone or other long-lasting materials
  3. Permanent plugs: Designed for long-term use in severe cases

The choice of plug type depends on the severity of the dry eye condition and the patient’s response to treatment. Ophthalmologists often start with temporary plugs to assess effectiveness before considering more permanent options.

The Mechanics of Tear Production and Drainage

To fully appreciate the role of punctal plugs in treating dry eye syndrome, it’s essential to understand the intricate process of tear production and drainage. The human eye’s tear film is a complex structure consisting of three main layers: the mucin layer, the aqueous layer, and the lipid layer. Each layer plays a crucial role in maintaining eye health and comfort.

The Three Layers of the Tear Film

  • Mucin layer: The innermost layer that helps tears adhere to the eye’s surface
  • Aqueous layer: The middle layer, composed mainly of water and nutrients
  • Lipid layer: The outermost layer that prevents rapid evaporation of tears

When any of these layers are compromised, it can lead to dry eye symptoms. Punctal plugs primarily address issues with tear volume and retention, helping to maintain a stable tear film on the eye’s surface.

Diagnosing Dry Eye Syndrome: Beyond the Obvious Symptoms

Accurately diagnosing dry eye syndrome can be challenging due to the wide range of symptoms and their varying intensity among patients. While some individuals may experience obvious signs of dryness, others might present with seemingly contradictory symptoms like excessive tearing. This complexity underscores the importance of a comprehensive eye examination by a qualified ophthalmologist.

Common Diagnostic Tests for Dry Eye Syndrome

  1. Schirmer’s test: Measures tear production
  2. Tear break-up time (TBUT): Assesses tear film stability
  3. Corneal staining: Reveals damage to the eye’s surface
  4. Meibomian gland evaluation: Examines oil-producing glands in the eyelids
  5. Osmolarity testing: Measures the concentration of tears

These tests, combined with a thorough patient history and symptom assessment, help ophthalmologists determine the most appropriate treatment plan, which may include the use of punctal plugs.

The Impact of Lifestyle and Environment on Dry Eye Syndrome

While medical interventions like punctal plugs can be highly effective in managing dry eye syndrome, lifestyle factors and environmental conditions play a significant role in the development and exacerbation of symptoms. Understanding these influences can help patients take proactive steps to alleviate their discomfort and complement medical treatments.

Key Lifestyle and Environmental Factors Affecting Dry Eyes

  • Extended screen time and reduced blinking
  • Low humidity environments (e.g., air-conditioned spaces)
  • Exposure to pollutants and irritants
  • Certain medications (e.g., antihistamines, antidepressants)
  • Dehydration and inadequate water intake
  • Poor sleep habits and eye strain

By addressing these factors in conjunction with medical treatments like punctal plugs, patients can achieve more comprehensive and lasting relief from dry eye symptoms.

Alternative and Complementary Treatments for Dry Eye Syndrome

While punctal plugs offer an effective solution for many dry eye sufferers, they are not the only treatment option available. A multifaceted approach often yields the best results, combining various therapies to address different aspects of the condition.

Exploring Other Treatment Options

  1. Artificial tears and lubricating eye drops
  2. Prescription medications (e.g., Restasis, Xiidra)
  3. Warm compresses and eyelid hygiene
  4. Omega-3 fatty acid supplements
  5. Intense Pulsed Light (IPL) therapy
  6. Autologous serum eye drops
  7. Scleral contact lenses

The choice of treatment depends on the underlying cause of dry eye syndrome, the severity of symptoms, and individual patient factors. An ophthalmologist can help determine the most appropriate combination of therapies, which may include punctal plugs as part of a comprehensive treatment plan.

The Future of Dry Eye Treatment: Emerging Technologies and Research

As our understanding of dry eye syndrome continues to evolve, researchers and medical professionals are constantly exploring new ways to diagnose, treat, and manage this complex condition. From advanced diagnostic tools to innovative therapies, the future of dry eye treatment looks promising.

Cutting-Edge Developments in Dry Eye Management

  • Nanotechnology-based drug delivery systems
  • Gene therapy for targeted tear production
  • Artificial intelligence for personalized treatment plans
  • Stem cell therapies for corneal regeneration
  • Novel biomaterials for improved punctal plugs
  • Wearable devices for continuous symptom monitoring

While many of these technologies are still in the research phase, they offer hope for more effective and personalized treatments in the future. As we await these advancements, current options like punctal plugs continue to provide relief for many dry eye sufferers.

Living with Dry Eye Syndrome: Strategies for Long-Term Management

For many individuals, dry eye syndrome is a chronic condition that requires ongoing management. While treatments like punctal plugs can provide significant relief, adopting a holistic approach to eye health is crucial for long-term success. By combining medical interventions with lifestyle modifications and self-care practices, patients can achieve better symptom control and improved quality of life.

Tips for Managing Dry Eye Syndrome in Daily Life

  1. Practice the 20-20-20 rule when using digital devices: Every 20 minutes, look at something 20 feet away for 20 seconds
  2. Use a humidifier in your home and workplace to increase ambient moisture
  3. Wear wraparound sunglasses to protect eyes from wind and irritants
  4. Stay hydrated by drinking plenty of water throughout the day
  5. Consider using preservative-free artificial tears as needed
  6. Maintain a balanced diet rich in omega-3 fatty acids and vitamin A
  7. Get regular eye check-ups to monitor your condition and adjust treatment as necessary

By incorporating these strategies into their daily routine, patients can complement the effects of medical treatments like punctal plugs and achieve better overall eye health. Remember, consistency is key when managing chronic conditions like dry eye syndrome.

As we continue to explore the complexities of dry eye syndrome and the various treatment options available, it’s clear that a personalized approach is essential. Punctal plugs represent just one of many tools in the arsenal against this pervasive condition. By working closely with eye care professionals and staying informed about the latest developments in dry eye management, patients can find the right combination of treatments to achieve lasting relief and maintain optimal eye health.

Punctal plugs – Mayo Clinic

One approach to treating dry eyes is plugging the openings to the tear ducts with tiny silicone plugs (punctal plugs). These plugs close the tiny opening (punctum) that you have in the inner corner of your upper and lower eyelids. The closure conserves both your own tears and artificial tears you may have added.

 

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My Eyes Tear Up When I Read or Go Outside, But My Doctor Tells Me I Have Dry Eyes!: Eye Care of East Bay: Laser Eye Surgeons

As a cornea specialist, I see a large number of patients who suffer from dry eyes.   

The symptoms of dry eyes can be quite variable amongst different individuals.  Some common features include eye burning, sandy/gritty feeling in the eyes, itching, light sensitivity, tiredness of the eyes when reading or working on the computer, and excessive tearing. 

Yes, you read that correctly. Some patients with dry eyes present with excessive tearing that sometimes occurs after being exposed to cold air, reading in bed, and windy conditions.

The reason for this is when we read for a period, we do not blink as much. This causes the eyes to get even drier and irritated.  In response, the tear gland goes into overdrive, and excessive tearing happens.  The same situation can occur when exposure to cold or hot air occurs.

Most of the patients who end up in my ophthalmology practice at Eye Care of East Bay have already had many of the usual treatments including artificial tears, gels, and eye ointment with limited response. Many are frustrated by lack of efficacy and the chronic nature of the condition.  The symptoms of dry eyes are rarely severe but decrease the quality of life and have a negative impact on mood and mental health.

In this blog, I am going to give you a brief review of dry eyes and its standard treatment.  In the next blog, I will review some of the less commonly used but very effective treatments for patients who do not respond to conventional therapies.

How Common is Dry Eyes?

It is difficult to know precisely how many patients suffer from dry eyes but it is estimated that at least 16 million people have chronic dry eye syndrome in the United States. On a typical day, I see at least 5-6 patients with dry eyes.  Most of my dry eyes patients are older and more commonly women.   This is partly because of hormonal changes – such as those that occur during pregnancy or menopause.

What Causes Dry Eyes?

Simply put, there are two general causes of dry eye.  Either there is not sufficient tear production or too much tear evaporates from the eye.

Usually, the most common cause of dry eye is the age-associated decrease in tear production.  As we get older, our tear glands do not produce as much tear as when we are younger. This is the most common type found in postmenopausal women.

Systemic disease such as Sjogren’s syndrome, rheumatoid arthritis, lupus, and others can also decrease tear production.

Finally, many medications such as sedatives, diuretics, antidepressants, blood pressure medications, oral contraceptives, antihistamines, nasal decongestants, and pain relievers can cause decrease tear production.

Dry Eyes can also be caused by rapid evaporation or premature destruction of the tears. In this condition, although there is sufficient tear production, the thin portion of the tears evaporates too quickly, leaving small amounts of salty liquid behind. This commonly happens when there is reduced blinking such as reading for an extended period or staring at the computer screen. Exposure to certain environmental conditions such as blowing fans, air-conditioning, pollen in the air, and others can cause more evaporation of tears.

Other factors such as long-term use of contact lenses and refractive surgeries, such as LASIK, can cause dry eyes.

What are the Treatments for Dry Eye?

Although there are many topical treatments for dry eyes, every patient is unique and will respond differently to available modalities of treatment.  I usually sit down with my patients and together we come up with a step-wise treatment plan going from simple to more complex.

Step 1:  Over the Counter Topical Artificial Tears, Gels, and Ointments

Frequent use of topical high-quality artificial tears can help many patients.  There are many different over the counter artificial tears available.   In general, the teardrops that are preservative free are gentler on the eye. The preservative containing drops can irritate with frequent use.

One general rule of thumb is that if the drops are used more than four times daily, preservative free tears should be used. The main problem with artificial tears is the short duration of effect.  While they provide some relief, the result does not last a long time.

There are also many artificial eye gel and ointments that can provide much longer relief.  The main problem with these is that they cause blurry vision.  The gels or ointments are ideal for nighttime use right before sleeping.

I also advise my patients to use warm compresses twice daily.  The use of warm compresses can help open up the glands at the eyelid margin.  These glands secrete oily material that helps moisturize the eye and decrease tear evaporation.

Step 2: Prescription Topical Medications

There are currently two FDA approved topical drops for the treatment of dry eyes in the US:

One is Restasis.   This is an anti-inflammatory eye drop that is used twice daily.  The decrease in inflammation allows the tear gland to start producing more tears.  So, it is not a teardrop but rather a tear producer.  It is important to know that not everyone responds to the drops and it can take 3-4 months of use to have an effect.  During that time, patients need to continue using their artificial tears. The medication does sting a bit when applied.  I have had some pleased patients with Restasis but also some patients who did not respond to it.

Another recent eye drop that is new to the US market is Xiidra.  It is also used twice daily, and it can help decrease symptoms of dry eyes. 

Both of these medications are prescription, and although many insurance companies are paying for them, without insurance the cost can be quite high.

Some of dry eyes patients present to my office with very inflamed and red eyes.  For some selected patients, a short course of topical steroid eye drops can be helpful.   This should be done only for a short duration under the supervision of an ophthalmologist to monitor for side effects.

Step 3: Punctal Plugs

Each eyelid (upper and lower) has a small opening close to the nose called the punctum.  The openings are connected to tear drainage ducts.  The job of these ducts is to drain excess tears away from the eye.  Dry eye patients do not have any excess tears to remove.  In other words, they need to hold on to every bit of tear they have.

One way to do this is to close the lower tear drainage duct by placement of a tiny plastic plug in the opening.  These devices are called punctal plugs, and they are generally about half the size of a grain of rice.  When the drainage duct is closed, the patient has more tears and less dry eyes.  This is similar to closing the drain in a sink.

The procedure is simple and can be performed in the office in a few seconds.  Some possible side effects include irritation of the eye due to the plug or over-response to the treatment with excessive tearing. Depending on the type of plug, the procedure can be reversed by removal of the plug in many but not all cases.

Conclusion

We have covered some of the most common treatment of dry eyes.  While many patients do respond to these treatments, there are patients with very severe dry eyes who continue to have symptoms despite these therapies.  In my next blog, I will cover some non-common but very effective alternatives.

In summary, although treatment of dry eyes can be challenging for both the patient and the ophthalmologist, with appropriate evaluation and regular follow up, the condition can be successfully managed in most patients.

If you experience any of these symptoms, you can arrange for a consultation at my office at the Eye Care of East Bay in Walnut Creek.

Watery Eyes and Dry Eyes

While it may seem counterintuitive, watery and runny eyes can actually be a sign of dry eye disease.  More specifically, they are an indication of an underlying condition known as Meibomian gland dysfunction, which is a factor that can worsen dry eye disease and affect ocular comfort.   Meibomian gland dysfunction, or MGD, interferes with the eye’s natural tears and can cause the eyes to water in addition to feelings of grittiness, irritation, or foreign body sensation.  Continue reading to learn more about Meibomian gland dysfunction and how this condition can cause watery eyes. 

Understanding Your Tears

The tear film is responsible for protecting and nourishing the ocular surface.  When the tear film is disrupted, we experience symptoms of dry eye disease. There are millions of small glands, called Meibomian glands, that line the eyelids and release an important oil, called meibum, into our tears.  This meibum creates what is known as the “lipid layer” of the tears – it forms the outermost coating of the tear film and helps stabilize the ocular surface. When the Meibomian glands are not properly functioning, and the lipid layer is not properly distributed into the tear film, tears will quickly evaporate and leave corneal surface exposed.   Because the cornea is highly sensitive, especially when it is unprotected, it makes reflex tears to attempt to cover the surface of the eye when the lipid layer is deficient. However, these reflex tears are poor quality tears that do not contain any meibum; instead of adequately coating the front surface of the eye to provide nourishment, they end up either immediately evaporating or running off the eye and down the cheeks.  This is how watery and runny eyes can actually be indicative of underlying dry eye disease. 

 

Treating MGD, Dry Eye and Watery Eyes

To treat watery runny eyes, you have to treat the underlying dry eye disease and promote proper Meibomian gland function.  One common treatment approach to Meibomian gland dysfunction is warm compresses. This includes using a warm washcloth or commercially prepared heat-retaining mask and holding it over the eyelids for 10-15 minutes.  The heat helps release any blocked or clogged Meibomian glands. Warm compresses can be followed by a soft lid massage to assure that the meibum is being properly released into the tear film. Nightly lid scrubs, either with a commercially prepared wet cloth or with warm water and soft soap, are also important for preventing any debris from clogging to the Meibomian glands.  In moderate to severe cases of MGD, treatment with a short course of antibiotics can be employed to eliminate any possible bacterial colonization and associated inflammation along the eyelids that is contributing to the dysfunction of the glands. Your eye doctor may also perform in-office gland expression, where they will manually press on the Meibomian glands and force the lipid layer back into the tears.  It is important to remember that, like treatment for dry eye disease, treatment for MGD is chronic and long-term. It may take time and consistency before a dramatic improvement in symptoms, like watery eyes, is noticed.  

 

If you or a family member are interested in learning more about meibomiangland dysfunction (MGD) and dry eyes,  ask your optometrist at Neal Eye Group about how we can help you improve your symptoms with different therapeutic options.

   Call us at (610) 828-9701 or schedule your appointment online for an eye exam with the Neal Eye Group.  We serve Conshohocken, Plymouth Meeting, Lafayette Hill, and Whitemarsh.

The 6 Most Common Signs Of Dry Eye

Posted in Uncategorized | March 23, 2020

With a name like dry eye syndrome, it would seem logical to assume that you would have dry eyes. But there’s a little bit more to this eye condition than that, and more common signs to watch out for. Keep reading to learn more about dry eye!

1. Dry eyes

Yes, one of the most common signs of dry eye syndrome is dry eyes. When your eyes are dry, it’s usually due to two things.

One, you aren’t producing enough tears, or two, the tears being produced are low-quality. In either case, it results in your eyes feeling drier than normal. But why are your eyes so dry?

Part of the problem could stem from the tear film in your eyes. In someone who doesn’t have dry eye syndrome, the tear film has three components: water, mucous, and oil.

When someone has dry eye syndrome, their tears are missing one or several of these vital components. If your tears don’t have enough oil or mucous, it can result in the frustrating symptoms of dry eye syndrome.

2. Irritation or gritty feeling

Another common sign of dry eye syndrome that goes along with having dry eyes is irritation. Generally, if your eyes are dry, they are also irritated.

They may also feel gritty, like something is in them, even if nothing is there. For most people with dry eye syndrome, the next logical step is to rub their eyes to alleviate the gritty feeling.

But this is actually the last thing you want to do! Rubbing your eyes in any capacity can cause an incredible amount of damage to them!

If your eyes feel irritated and you get the urge to rub them, resist and use artificial tears instead. When your eyes are too dry, using artificial tears or eye drops can help if your eyes start to bother you.

3. Watery eyes that won’t stop tearing up

When people hear the phrase “dry eye syndrome” the last sign they would expect is someone experiencing watery eyes that tear up. But watery eyes that won’t stop tearing up are another common sign that you may have dry eye syndrome.

Remember that some of the reasons people develop dry eye syndrome is because of tear production or because they produce low-quality tears. For people with dry eyes, they may have eyes that won’t stop watering because their tears aren’t high quality.

The tears may have too much or too little water in them, making them less beneficial for the eyes. Tears are a crucial component that keeps the eyes lubricated and moisturized.

4. Sensitivity to light

If you don’t have dry eyes, it can be difficult to understand what the condition feels like. If you’ve ever been to a movie theatre, think about how uncomfortable it feels when you make it outside into the sun.

After two hours in the dark, it can take your eyes a few minutes before they adjust to the sunlight again! Now imagine that’s how your eyes feel all the time, and you have a good idea of how someone with dry eye and light sensitivity might feel.

The problem with dry eye syndrome is if you leave it alone, it will only get worse over time. There’s nothing worse than having eyes that feel uncomfortable all the time!

5. Difficulty wearing contact lenses

When you have dry eyes, little tasks become a lot harder. For some people, this can mean that wearing contact lenses becomes difficult.

When most people put in their contacts, they wear them for eight hours a day. Contacts cover the surface of the eye and can soak up much of the eye’s fluids.

With dry eye syndrome, wearing contact lenses can become downright painful or impossible. Your eyes may become red, itchy, or even start hurting when you wear contact lenses.

Having dry eyes is one reason many contact lens wearers consider procedures like LASIK. After all, why wouldn’t you want to find a way to no longer need to touch your eyes multiple times a day if you could?

If someone with dry eye syndrome was thinking about LASIK, they would need to have their symptoms under control before getting the procedure. Undergoing something like LASIK with an active case of dry eye can lead to severe complications and worsening dry eye symptoms.

6. Itchy eyes

Although allergy season is right around the corner here in Griffin, experiencing itchy eyes all year isn’t an allergy symptom, it’s a sign of dry eyes. Having itchy eyes along with irritation, watery eyes, and grittiness is a sign that you should talk to your eye doctor about dry eye syndrome.

If you happen to have allergies and think you may have dry eyes as well, talk to your eye doctor sooner than later. Dry eye symptoms have a tendency to get worse during allergy season, not better.

It’s better to be prepared and know what you’re up against before pollen starts floating around and coating every surface around you!

What you can do to help your dry eyes now

If your dry eyes are bothering you right now, there are things you can do to find relief. Try some of the following tips:

Drink more water

If your eyes are dry, it can often be a sign that the rest of your body is also dehydrated. If you feel thirsty, you’re already showing signs that you aren’t drinking enough water!

Aim for at least 8 eight-ounce glasses of water every day. You’ll see benefits to your skin, eyes, and even your energy levels!

Eat more foods with Omega-3 fatty acids in them

If your eyes are dry, your diet could use some overhauling. Try eating more salmon, tuna, watermelon, walnuts, and chia seeds and see if you see any improvements.

Make some small lifestyle changes

They don’t have to be extreme but think about making some changes like buying humidifiers. Put them in the rooms that you’re in the most like your bedroom or living room.

Humidifiers are a great way to add moisture into the air, which your dry eyes will most certainly benefit from.

Get enough sleep at night

If you want to be healthy, inside and out, you need to make sure you’re getting enough sleep every night. Tired eyes are more likely to feel dry, so try to get at least seven to eight hours of sleep.

Do this every night, including on the weekends. Consistency is key if you want your eyes to feel better and to stay that way!

Tried these tips and not seeing any changes? It may be time to see an eye care professional for dry eye treatment.

Schedule an appointment to discuss your dry eye options at Takle Eye Group in Griffin, GA today!

Why Are My Eyes Watery?

Have you recently found your eyes watering unexpectedly? If so, don’t worry—you’re not alone. Watery eyes can affect people at any age, and numerous factors can cause them. It might sound strange, but watery eyes can even result from dry eye disease!

Visiting your eye doctor for an exam is the best way to determine why your eyes are watering, but we’ve provided some possible explanations below to help you get started. Read on to learn more about what causes watery eyes and inform yourself before reaching out to your optometrist.

Poor Drainage or Excessive Tearing? 2 Culprits Behind Watery Eyes

There are two main reasons that a person’s eyes might water: either their tear ducts are blocked, or their eyes are producing too many tears. However, either of these scenarios can result from various conditions, and some conditions (like dry eye disease) can cause both.

Blocked Tear Ducts

Blocked tear ducts are a commonly misunderstood reason for watery eyes. Many people assume that the tear ducts exist to produce tears, but that isn’t true. The tear ducts exist to drain tears into your nose through tiny holes called puncta. If the tear ducts are blocked, the eyes may water instead.

Newborn babies often experience watery eyes due to blocked tear ducts. Their eyes typically begin to produce tears after only two weeks, but their tear ducts may not open until they are seven or eight months old. Until the tear ducts can drain moisture properly, the infant’s eyes will likely water instead.

Adults may also experience blocked tear ducts since the puncta become narrower with age. Inflammation (a common cause of dry eye disease), injury, and certain medications or medical treatments can also create blockages in a person’s tear ducts.

Tear Overproduction

There are many different reasons why a person’s eyes could produce too many tears. However, dry eye disease is one of the most common. Dry eye causes irritation that can provoke reflex tearing, causing a person to cry more frequently than usual.

Several other conditions can also cause a similar kind of irritation to that of dry eye disease. These include:

  • Eyelid inflammation or blepharitis, which can also lead to dry eyes
  • Conjunctivitis (either allergic, infectious, or chemical)
  • Common cold complications
  • Physical damage to the cornea (from a scratch or a foreign object lodged in the eye)
  • A stye or ulcer
  • Hay fever
  • Keratitis
  • And more

Visiting an optometrist is the best way to find out why your eyes are producing too many tears. Your eye doctor will also be able to recommend a course of treatment for you, based on the reasons for your watery eyes.

Common Treatments for Individuals with Watery Eyes

Many patients come to us to learn more about why their eyes are watering. In many cases, we find that a patient’s watery eyes result from dry eye disease. However, other treatments are available for people whose eyes water for different reasons.

Treating Dry Eye Disease

We treat dry eye disease in numerous ways. Some of the most effective methods include:

  • Blephex: this medical device allows an optometrist to remove debris from the eyelashes and eyelids. Cleaning these areas can reduce inflammation in patients whose dry eyes have been caused by blepharitis.
  • Xiidra: these eye drops help your body regulate specific proteins that may cause dry eyes by disrupting the delicate balance of substances required for healthy tear production.
  • Restasis: these prescription eye drops include cyclosporine, an anti-inflammatory that can help treat dry eye disease’s underlying causes.
  • Punctal Plugs: sometimes, dry eye disease occurs when a person’s puncta drain their tears too quickly. In these cases, we insert tiny plugs into the puncta to prevent drainage so the eye can moisten adequately again.

Even people whose tears drain too quickly can experience watery eyes. The irritation associated with dry eye can provoke more reflex tearing than their tear ducts can drain. The result can be a person whose eyes are uncomfortably dry between bouts of frequent crying.

Treating Other Causes of Watery Eyes

Your optometrist may recommend other treatments for watery eyes caused by:

  • Conjunctivitis: eyecare professionals may use antibiotics to reduce inflammation caused by conjunctivitis. However, they typically wait a week or so first to see if symptoms decrease naturally.
  • Foreign objects: if an item is stuck in your eye and causing it to water, your eye doctor will take it out safely. Foreign objects may include ingrown eyelash hairs.
  • Styes or ulcers: your optometrist can help drain a stye to reduce the discomfort it causes. Corneal ulcers can require medications or surgeries, depending on their severity.

Talk to Your Eye Doctor about Watery Eyes

Many different factors can lead to watery eyes, so it’s best to consult your optometrist instead of diagnosing the cause yourself. Qualified eye care professionals have the resources and experience necessary to tell you exactly why your eyes are watering and what to do about it.

Looking for dry eye relief

Speaking of Health


Individuals often take eye health for granted. However, for many people, dry eye disease is a very real condition that affects their daily lives. People with dry eye disease often produce poor quality tears, poor quantity of tears or both, which leads to chronic inflammation of the eye surface.

I have dry eyes, but my eyes are watery all the time. How can that be?

There are three kinds of tearing: basal (basic), emotional and reflex tears. In dry eye disease, it’s the basal tears that are of poor quality and quantity. Emotional tearing occurs when individuals are upset or moved by a sensitive situation. In this instance, there are plenty of tears; however, they’re typically poor quality. Reflex tearing occurs when something gets in your eye and the eye tries to flush it out. Again, this is a situation where there are excessive tears of poor quality. When your eyes get dry enough, they act as if there is something in them and try to flush it out, which leads to watery eyes. In fact, watery eyes are the No. 1 complaint of dry eye sufferers.

What factors contribute to dry eye?

  • Normal aging changes your eyes, and they don’t function as well as when you’re younger.
  • Changes in hormone levels associated with age, menopause, pregnancy or birth control pills affect the eyes.
  • People who have acne rosacea (50 percent have dry eyes), diabetes, thyroid disease, autoimmune diseases and inflammatory diseases that include rheumatoid arthritis (often dry eye disease is a presenting symptom), lupus and Sjogren’s syndrome are more likely to develop dry eyes.
  • Oral medications, including antihistamines, antidepressants and birth control pills, can increase the likelihood of dry eyes. Preservatives found in medicated eye drops that are used chronically, including glaucoma drops and in cheap artificial tears, can also worsen the symptoms of dry eye. Make sure to avoid drops that claim to get the red out. These can lead to rebound red eyes, which cause eyes to be even redder and more irritated than before.
  • Irritation from secondary smoke, as well as the internal effects of smoking may lead to dry eyes.
  • The standard American diet, which is high in omega-6 fatty acids and low in omega-3 fatty acids, is also a factor. Omega-6 fatty acids cause inflammation, a key component to dry eye disease. A heart-smart diet is an eye-smart diet, such as the Mediterranean diet.
  • The health of your eyelid margins and eyelashes is important. Blepharitis (dandruff like debris called scurf) Meibomian, gland dysfunction (poor quality oil, atrophy of glands), ocular rosacea, irregular eye lid margins (scaring, notching), Demodex (mites living in eyelash follicles) can all play a role in dry eye disease.
  • Wearing contacts disrupts the tear film, leading to dry eye symptoms and decreased contact comfort and wearing time. Existing dry eye disease can lead to poor successful contact lens wear.
  • Dry, windy, dusty and smoky conditions can all be problematic. So is polluted air quality, including second-hand smoke and seasonal air quality.
  • A poor blinking rate (normal rate 15 bpm, poor is 4-5 bpm) can affect your eyes. Incomplete blinking (60-70 percent when working on digital devices) can also lead to dry eyes.
  • Many people are vitamin D deficient. This contributes to dry eyes, along with many other health issues.

Is there anything I can do to improve my dry eye disease?

Yes, but it takes time. Your dry eye disease didn’t occur overnight. It took many months or years to develop, and it’s not going to go away immediately. Start by seeing your eye doctor and discussing your symptoms. Many people fail to mention these issues to their eye doctor because they don’t see them as important.

How your eye doctor can help

Your doctor will work to evaluate your symptoms and the quality and quantity of your tears.

  • First. The doctor will ask questions about your symptoms including when, where, how often and what you’re doing when they occur.
  • Second. The doctor will ask questions about your general health and the medications you’re taking.
  • Third. A quality evaluation is performed of your eyelashes, eyelid margins, Meibomian glands and the surface of the eyeball (the conjunctiva and cornea).

Once an evaluation is complete, your doctor will design a treatment plan in a stepwise format to improve the environment for your eyes and your dry eye disease. There’s no magic wand to make dry eye disease instantly better. However, if a treatment plan is followed and you learn and use new habits, your dry eye disease can be improved.

Treatment options may include the following:

  • Address eyelash and eyelid appearance and inflammation — through hygiene, supplements and prescription drops.
  • Monitor quality and quantity of the Meibomain gland oil — using supplements, hot compresses and other treatments.
  • Quiet eye surface inflammation ­— with artificial tears, supplements and prescription drops.
  • Increase quantity of tears — using artificial tears, prescription drops and tear duct (punctal) plugs.
  • Control your environment — with a humidifier; no forced air across the face.
  • Diet — supplements.
  • Follow up visits with your eye doctor — to monitor treatment and make adjustments.

Robert Friese, O.D., is an optometrist at Mayo Clinic Health System in Fairmont. 


For the safety of our patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was either recorded prior to COVID-19 or recorded in a non-patient care area where social distancing and other safety protocols were followed.

Dry Eye Symptoms and Treatment

We know what you’re thinking: it sounds counter-intuitive, but having watery eyes is actually a sign that you might have dry eye syndrome! Living with dry (yet watery) eyes can be difficult, but once you discover the specific cause, it may be easy to treat. We took some time to explore the watering that can accompany dry eye — its causes, symptoms, and treatments.

What is Dry Eye, Anyway?

With each blink of the eyelids, tears are spread across the cornea, the front surface of the eye. Tears have many important functions: they provide lubrication and moisture, keep the surface of the eyes smooth, wash away foreign debris, and help prevent eye infections. Dry eye syndrome — also called ocular surface disease — occurs when tears aren’t being produced in the quantity, or the quality, needed to perform all of these functions.

Symptoms of Dry Eye

While one of the main signs of dry eye is watery eyes, there are many other symptoms that can further indicate that you are suffering from dry eye syndrome, including:

  • Itchy, painful eyes
  • Redness
  • Blurred vision
  • Swollen eyelids
  • Stringy mucus
  • Sensitivity to light

What Causes Dry Eye?

Many factors can cause decreased tear production and quality, including your genetics, lifestyle, and environment.

When your eyes don’t produce enough tears, they can’t be properly moisturized, lubricated, and protected. Being exposed to wind or dry climates can cause tears to evaporate too quickly. Tear production can also diminish depending on your age, medical condition, lifestyle, and the medication you may be taking.

Why Are My Eyes Watering?

When your eyes become dry, the glands beside your eyes begin to produce tears in order to try to sooth the itchiness, burning, and irritation. The glands will over-compensate, producing so many tears that the eyes can’t drain away the tears fast enough, causing the feeling of constant wet and watery eyes.

It’s also possible that your dry eye is caused by tears not staying on your eye’s surface long enough to relieve the dryness. These tears either dry up too quickly or drain too quickly. This failure of the tears to actually improve your dry eye symptoms will just cause your glands to continue producing tears, leading to consistently watery eyes.

Blocked tear ducts are yet another cause for dry eye syndrome. When the tear ducts can’t drain tears from the eye (because they’re blocked due to a “foreign body” or eye injury), it can cause excessive watering in your eyes.

It’s Time to Reduce Watery Eyes and Relieve Dry Eye

Living with dry eye can affect your quality of life, especially when the pain of dry eye causes your eyes to excessively water. At Central Oregon Eyecare, we take special care to determine the specific cause of your dry eye, and provide you with the treatment you need to relieve your symptoms.

When you’re ready to find relief for your dry eye syndrome, schedule an appointment or call us at (541) 640-5242.

Dry eye syndrome: symptoms, causes, recommendations

October 21, 2021

Inhale-exhale: how to quickly check the quality of your breathing

We cannot help breathing, the absence of breath means the absence of life. To be healthy and energetic, you need to have even and easy breathing. What is your breathing? Maybe you don’t know something about yourself? This test should help determine if you have respiratory problems.

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