Eye

Watery eyes blurry vision: Watering eyes | nidirect

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Watering eyes | nidirect

Watering eyes happen if too many tears are produced or they can’t drain away properly. It can cause blurred vision, sore eyelids and sticky eyes. See your optician or GP if you have persistent watering eyes or any lumps or swelling around your eyes.

Causes of watering eyes

Watering eyes can affect anyone. It’s most common in young babies and people over 60.

A problem with the glands

Glands in the eyelids (Meibomian glands) normally secrete an oily substance. This substance slows the evaporation of tears between blinks.

When these glands don’t function properly, it can result in dry patches on your eyes.

These become sore and extra tears are produced as a reflex. This is the most likely cause of watering eyes.

Other causes

Other problems that can cause extra tears to be produced include:

  • the lower eyelid sagging away from the eye (ectropion) – this makes it difficult for tears to reach the drainage ducts
  • eyelids that roll inwards (entropion)
  • inflammation of the edges of the eyelids (blepharitis)
  • blocked or narrowed tear ducts
  • eye irritation (for example, from chemical fumes or grit)
  • an eye infection, such as conjunctivitis
  • an allergy

Investigating and treating watering eyes

See your optometrist (optician) for a check up if you think your eyes are watering more than normal.

You may be advised to see your GP. Your GP will treat your symptoms, or treat the condition causing your symptoms.

They may refer you to an eye specialist called an ophthalmologist for an examination.

This may be because no obvious reason for your watering eye can be found, or because your symptoms are difficult to treat.

Investigating the cause

If you are referred, an ophthalmologist, they may carry out tests to look for blockages in your tear ducts.

A pharmacist may be able to help 

A pharmacist may be able to tell you:

  • what you can do to treat it yourself – such as cleaning and protecting your eyes
  • if you can buy anything to help – such as cleaning solutions, eye drops or allergy medicines
  • if you need to see an optician or GP

Treatment

If you’re producing extra tears as a result of dry eye syndrome, you may be offered lubricating eye drops. You may also be advised to avoid activities that make your symptoms worst.

Your GP or consultant ophthalmologist will advise if medication may be needed. This is if the cause is an allergy or infection. Surgery may be needed if a tear duct is blocked.

If the symptoms aren’t interfering with your life, you may choose not to have treatment for your watering eyes.

  • Find out more about watering eyes on the NHS website

More useful links

  • How to use your health services

This page was reviewed January 2019

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What’s Behind Watery Eyes?

When you produce too many tears, or when your normal tear drainage system is blocked, your eyes may get so watery that your tears can spill onto your eyelids and cheeks as though you were crying.

Is there anything you can do about it? Yes, depending on the cause.

What Are Tears?

Tears are essential for seeing clearly, says the National Eye Institute. Every time you blink, you’re washing your eyes with a “tear film” that nourishes the tissue and provides necessary lubrication.

This film is produced by glands and cells located in the tissues around your eyes, and it consists of an oily layer, which helps to prevent evaporation; a watery layer; and a mucus layer, which helps the tears stick to the eye surface.

When you blink, the tear film is distributed over the surfaces of your eyes. It then either evaporates or drains into your nasolacrimal ducts, located in the inside corners of your eyes.

An abnormality in one of these four processes — tear production, distribution, evaporation, and drainage — can lead to overly dry eyes or overly wet eyes, also called epiphora.

What Causes Overproduction of Tears

Frequently, people with watery eyes are experiencing an overproduction of tears. These excess tears can be caused by a variety of causes, including the following:

Dry Eyes

While it may seem counterintuitive, one of the symptoms of dry eye disease is excess tearing, or watery eyes. Other symptoms include stinging, burning, irritation, and a gritty feeling, all of which can lead to excessive watering, according to StatPearls.

Many things can cause dry eyes, from certain medications, to environmental irritants such as cigarette smoke, to diseases of the eye or the skin around the eyes, to systemic diseases such as Sjögren’s syndrome, to extended use of computers or other digital devices.

Tear production also tends to lessen with age, per the Mayo Clinic, so dry eyes become more common in older adults.

Dry eye is treatable, though finding the underlying cause is key. Until you can do that, you can manage your symptoms by reducing screen time, avoiding environmental triggers, sleeping with a humidifier, and using artificial tears or eye drops.

If necessary, your doctor may prescribe topical or oral drugs, perform a procedure in which tiny, removable silicone plugs are inserted into your tear ducts (called punctal occlusion), or recommend special contact lenses for people with dry eyes, among other things.

Allergies

Foreign proteins that your body overreacts to are called allergens. Allergic reactions can prompt all sorts of bodily symptoms, including red, itchy, and watery eyes — which is called allergic conjunctivitis.

This symptom is often — but not always — accompanied by allergic rhinitis, which involves symptoms like sneezing, an itchy nose, and nasal congestion. Most cases are caused by either seasonal allergens like pollen or year-round offenders like mold, dander, or dust mites.

You may be able to prevent this kind of watery eye reaction by avoiding allergic triggers in your environment. If not, nonprescription antihistamine eye drops may help. And if over-the-counter allergy treatments aren’t providing enough relief, you should consult your primary care doctor or possibly an allergist.

RELATED: Itchy Eyes: Is It an Allergy, Infection, Dry Eye, or Something Else?

Infection

Part of your body’s response to an eye infection can be to produce excess tears.

Conjunctivitis (inflammation of the tissue that lines the eyelids) and blepharitis (inflammation of the eyelid margins) are two infectious diseases known to cause watery eyes. (They can also have noninfectious causes.)

Pink eye is a common term for conjunctivitis, which can be bacterial, viral, or allergic. Determining the cause of a specific case is key to finding the right treatment. If it’s caused by bacteria, your doctor will likely recommend antibiotics; for viral pink eye, artificial tears and cool compresses may be recommended to minimize symptoms.

Blepharitis can be caused by bacteria, dandruff, rosacea, mites, and herpesvirus. Washing the eyes and eye area and applying warm compresses may be enough to treat blepharitis, but antibiotics may be needed to treat an infection.

Irritants

Your eyes produce excess tears in response to other types of irritation, such as an eyelash, dust, or some other foreign object in the eye. Once the object has been removed, the excessive tearing should stop.

Blocked Tear Ducts

Watery eyes may also be due to a blockage of the ducts that normally drain away tears, a condition called nasolacrimal duct obstruction.

About 6 to 20 percent of babies are born with this condition, according to StatPearls, although most cases in infants get better on their own or with conservative treatment.

Adults can develop it, too, especially middle-aged and elderly women, according to a review in Optometry.

Nasolacrimal duct obstruction in adults may be caused by infections, inflammation, tumors, traumatic injury, and other types of mechanical blockages.

According to the American Academy of Ophthalmology, surgery is usually needed to treat it, although medical treatments such as antibiotics, steroids, and chemotherapy and radiation may also be used.

Eyelid Problems That Lead to Watery Eyes

Poor eyelid function can lead to watery eyes. Here’s how: For tears to spread evenly over the eyes and be pushed to the corners of the eye for proper drainage, the eyelids need to close correctly.

An outward turning of the eyelid margin, called ectropion, prevents the eye from closing fully, resulting in dryness and watering. Ectropion usually affects the lower eyelid, according to StatPearls.

It is usually seen in older people, who gradually lose elasticity in their skin, though excess eye rubbing and eyelid pulling can worsen it.

Ectropion can be corrected with surgery that repositions the eyelid to its correct place.

Over-the-Counter and Home Remedies

Unless they are accompanied by eye pain or redness, excess tears are usually more of an annoyance than a serious problem. You may be able to find relief by using over-the-counter eye drops, such as:

  • Lubricating Eye Drops Artificial tears can help to keep your eyes moist and will also help wash away any irritants like dust that may be causing your eyes to water.
  • Antihistamine Eye Drops If allergies are making your eyes itchy and watery, antihistamine drops can help ease those symptoms. Products include ketotifen (Zaditor, Alaway, Zyrtec Itchy Eye) and olopatadine (Pataday). Antihistamine eye drops can burn or sting when placed in the eyes.

Some steps you can take to prevent dry, itchy eye irritation include:

  • Remembering to blink regularly when using your computer and to take occasional breaks to look away from the screen and rest your eyes
  • Resisting the urge to rub your eyes, as your hands can potentially introduce more allergens and irritants into your eyes
  • Using a humidifier in your home or work environment
  • Wearing sunglasses to protect your eyes from pollen, sun, and wind exposure
  • Using a cold compress over your eyes to temporarily relieve discomfort
  • Practicing good contact lens hygiene, including washing your hands before touching your eyes
  • Drinking plenty of water, as some research has found a link between dehydration and dry eyes

When to See Your Doctor About Excessive Tearing

If your watery eyes don’t clear up with over-the-counter treatment, consider getting medical attention to see if there’s a way to make you more comfortable.

You should consult your primary care doctor or eye doctor if you are experiencing the following:

  • Unexplained tearing over a long period of time
  • Watery eyes that are also red and producing discharge
  • Watery eyes and eye pain, which can be a sign of thyroid eye disease
  • Watery eyes and sore sinuses

Your doctor will examine your eyes to determine what’s causing your symptoms and, if appropriate, perform tests on the quantity and quality of your tears and look at how your eyes drain away tears. If you have an infection, your doctor can prescribe antibiotics or, if you have dry eyes or allergies, suggest other treatments. If it appears your watery eyes are related to a systemic disease, your doctor may refer you to a specialist for further treatment.

Additional reporting by Chris Iliades.

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Watery eyes. Why, what reasons? What to do? How to treat

Watery eyes or lacrimation – a condition when a tear accumulates in the conjunctival cavity and flows over the edge of the eyelid. The result is irritation of the skin of the eyelids, redness, maceration. Constantly flowing tears cause discomfort and irritation.

Why are the eyes watering and what to do?

Watery eyes only for three reasons:
A. Lacrimal glands produce excessive amounts of lacrimal fluid .

B. Disturbance of the lacrimal ducts .

S. Violation of the composition of tears .

Tears are essential for permanent hydration of the cornea. With a lack of tears, the cornea dries up, becomes cloudy and the person loses sight. This disease is called corneal xerosis. Therefore, to maintain good vision, the release of tears is necessary.

Interestingly, produces approximately 250 ml of lacrimal fluid per day in each eye. The same amount of tears is removed from the eye along the lacrimal ducts, which include the lacrimal canaliculus, lacrimal sac and nasolacrimal canal.

Each human eye has a lacrimal gland, which is located in the upper-outer part of the eye, and 18-20 small additional lacrimal glands in the transitional conjunctival fold of the upper eyelid, at the top of the eyelid from the inside.

Under normal conditions, only accessory lacrimal glands are constantly functioning and secreting tears. This tear is completely enough for a person to moisturize the cornea.

The main lacrimal gland is included in the work when the cornea dries up, it is irritated by a foreign object, or during psychological (neurological) irritation.

Watery eyes, what could be the reasons?

A. Causes causing hypersecretion of the lacrimal glands:

1. “Dry Eye Syndrome”

2. Dry air

3. Foreign body in cornea or conjunctiva

4. Chemical irritation of the cornea

5. Inflammatory process in the conjunctiva (conjunctivitis)

6. Inflammatory process of the eyelids (blepharitis)

7. Irritation of the nerves innervating the lacrimal glands, neurological cause of lacrimation

8. Violation of the psychosomatic state

B. Causes of disruption of the outflow of tears:

1. Atony (flabbiness) of the lower eyelid

2. Blockage of the lacrimal ducts

3. Inflammatory process in the lacrimal ducts

4. Narrowing of the lacrimal ducts

5. Inversion or eversion of the lacrimal openings.
6. Compression of the lacrimal ducts by eyelid edema

C. Causes leading to disruption of the tear composition:

1. Meibomitis – inflammation of the meibomian glands

A. Causes causing hypersecretion of the lacrimal glands:

1 “Dry Eye Syndrome”.

Paradoxically, but it is the “dry eye syndrome” that is one of the two most basic causes of lacrimation. It would seem that a “dry eye” requires hydration and cannot be the cause of excess tears. But it is the drying of the cornea that triggers the hypersecretion of the lacrimal gland, which produces a larger volume of tears than the lacrimal ducts can divert.
Treatment : Drops of artificial tears, restoring the tear film and, most importantly, its normal composition, will help get rid of lacrimation in this case. Massage of the meibomian glands is also recommended to restore their normal functioning. Violation of the function of the meibomian glands leads to a violation of the composition of the tear and, as a result, to the “dry eye syndrome”. It is also necessary to humidify the air in the room, especially in winter. The relative power of air for the normal functioning of the lacrimal organs should be more than 50%.

2 . Dry indoor or outdoor air causes tears to dry out and cornea to dry out. This effect is especially pronounced in countries with hot climatic conditions, accompanied by persistent winds. The mechanism of additional production of tears, which is produced in excess, is launched, and lacrimation occurs.

It should be noted that frosty air in terms of its physical characteristics is much drier than warm air. Therefore, on the street in the cold, accompanied by the wind, the tears also dry quickly and, as a result, additional increased secretion of tears by the lacrimal gland, from which the eyes water heavily.
Treatment : maintain indoor relative humidity above 50%, avoid prolonged outdoor exposure to extremely dry warm or frosty air accompanied by strong winds.

3 . A foreign body in the cornea or conjunctival cavity , most often an eyelash, leads to a violation of the corneal epithelium, causing a “corneal” syndrome, which is always accompanied by redness and watery eyes.
Treatment : it is necessary to remove the foreign body and use means that improve the regeneration of the cornea for its speedy recovery: eye drops or Korneregel gel, Solcoseryl eye ointment, Citral eye drops 2-3 times a day. After the restoration of the cornea, the lacrimation will stop. Along with drugs that improve regeneration, it is recommended to use eye drops to prevent a secondary infection, such as: “tobrex”, “albucid 20%”, “levomycetin” – 1 drop 3 times a day.

4 . Chemical irritation of the cornea by substances in the air leads to a reflex increase in lacrimation for increased protection of the cornea, to prevent the negative effects of chemicals on the eye lens, which are washed away by the abundant release of tears. We know that our eyes water when we peel onions. This is the most typical example of lacrimation from chemical exposure to the eyes. The same happens in a room where there is an excess of ammonia, tobacco smoke, and other active chemicals.
Treatment : Rinse eyes with warm water and evacuate. For prevention it is necessary to use goggles.

5. Conjunctivitis or inflammation of the mucous membrane of the eye also causes watery eyes. In addition to the fact that a tear flows, the eyes become red. With bacterial conjunctivitis, the discharge of pus, swelling of the eyelids joins.
Treatment : The cause of conjunctivitis must be determined and treated with drugs that inhibit the growth of viruses or bacteria. These can be: “tobrex”, “tobradex”, “maxitrol”, “interferon”, “albucid 20%”, “levomycetin” – 1 drop 4-6 times a day.

6 . Blepharitis , or inflammation of the edges of the eyelids, leads to chronic lacrimation, like the disease itself, which most often has a chronic course. Tearing in blepharitis is associated with swelling of the eyelids and difficulty in the outflow of tears through the lacrimal canaliculi.
Treatment : Treatment of the underlying disease of blepharitis will help to get rid of lacrimation in this case.

7 . Irritation of the nerves innervating the lacrimal glands , neurological cause of lacrimation. The innervation of the lacrimal gland is very complex. Four nerves provide its sensitive and secretory functions. This is the “Lacrimal Nerve” – ​​the first branch of the trigeminal nerve, a branch of the facial nerve, as well as nerve fibers of the parasympathetic and sympathetic nervous system. Irritation of these nerve fibers can cause hypersecretion of the lacrimal gland. The irritating factors include tumors, inflammatory diseases on the face, injuries.
Treatment : what to do in this case to stop lacrimation, neuropathologists can tell.

8. Violation of the psychosomatic state of a person is a common cause when the eyes water in excess and tears flow like a river. Anger, fear, sadness or grief cause irritation of the sympathetic nervous system, releasing the so-called “stress reaction hormones” into the blood – adrenaline, norepinephrine. As you know, the lacrimal gland is innervated by the sympathetic nervous system and therefore, when it is irritated, increased production of tears occurs. The stronger the stress response, the greater the irritation of the sympathetic nervous system and the more tears flow.
Treatment : drugs that stabilize the nervous system and reduce stress. Very suitable “Novopassit”, “Valerian extract”

B. Causes that cause disruption of the outflow of tears:

1. The second most common cause of lacrimation is atony (decreased tone) of the lower eyelid .
The tear flows from the conjunctival cavity through the lacrimal opening located on the lower eyelid. Normally, the eyelid has a good tone and the point is adjacent to the eyeball.

With age, muscle tone changes, the tone decreases, the eyelid becomes flabby and a small gap forms between the eye and the eyelid. The lacrimal opening moves away from the eyeball, the tear cannot find an outflow path and overflows over the edge of the eyelid. This happens when the eyes watery with age-related disorders in the body – atony of the lower eyelid.
Treatment : treatment in this case can only be surgical. There are two directions of treatment: it is the expansion of the lacrimal opening or excision of a part of the lower eyelid to increase its tone and return to its original state, when the lacrimal point is again adjacent to the eyeball and the tear outflow path is restored.

2. Blockage of the lacrimal ducts can be at any stage. In adults, blockage of the lacrimal ducts most often occurs. The cause of blockage can be discharge from conjunctivitis, blepharitis, mascara and other similar reasons.

Violation of the outflow in the lacrimal sac occurs after inflammatory diseases of the lacrimal ducts, dacryocystitis, canaliculitis. In such cases, the products of inflammation remain in the lacrimal sac and prevent the outflow of tears.

Diagnosis is carried out by obtaining x-rays with a contrast agent that fills the lacrimal ducts.
Treatment : Disturbance of the conductivity of the lacrimal ducts is carried out by their expansion and washing. As a rule, such procedures give a stable positive effect.

3. Inflammatory process in the lacrimal ducts . Dacryocystitis is an inflammation of the lacrimal gland. Dacryocystitis is characterized by the accumulation of inflammatory products in the lacrimal sac, its swelling, redness and soreness in the area of ​​​​the internal adhesion of the eyelids. At the same time, tears, as a rule, “run in a stream.” Canaliculitis – inflammation of the lacrimal ducts. Diagnosis of canaliculitis is difficult, as there are no outward signs of inflammation other than lacrimation.
Treatment : Treatment must be carried out in a specialized surgical facility, since successful treatment of dacryocystitis requires the creation of an outflow tract for the inflammatory fluid of the lacrimal sac, which is performed surgically.

4. Narrowing of the lacrimal ducts , or their stricture, is usually a consequence of inflammatory processes in the eye – conjunctivitis, inflammation of the eyelids, blepharitis. Violation of the epithelial wall of the lacrimal ducts due to infection leads to a narrowing of the lumen and to a violation of the outflow of tears.
Treatment : Bougienage of the lacrimal, nasolacrimal canals. If there is no effect, they resort to plastic surgery.

5. Inversion or eversion of the lacrimal openings – is the result of trauma or very severe inflammation of the eyelids. As a result of the scarring process, the lacrimal punctum is displaced, the tear cannot flow along the lacrimal ducts. The eyes are very watery.
Treatment : Cosmetic treatment of torsion or eversion of the lacrimal punctum can only be surgical.

6. Compression of the lacrimal ducts by swelling of the eyelids – the most common cause of lacrimation in the morning . If the eye is very watery in the morning, pay attention to whether you have swelling of the eyelids and face.
A person’s low mobility at night and a violation, especially with age, of the water-salt balance leads to stasis (slow flow) of fluid in the body, which accumulates in tissues rich in fiber, which include the eyelids. Excessive accumulation of interstitial fluid compresses the lacrimal ducts and can lead to severe lacrimation in the morning, which disappears as the person wakes up and moves.

Nocturnal lymphostasis, which occurs for a variety of reasons, from heart failure, kidney failure to varicose veins, can be the cause when tears flow in the morning.
Treatment: if, in addition to tears in the morning, you notice swelling of the eyelids, then it is necessary, at least for a few minutes, to carry out active physical exercises. The work of the muscles will improve lymphatic drainage, swelling of the eyelids will subside and tearing will stop.

In order to more accurately understand the malfunctions of the body, it is necessary to consult a therapist, who, based on examinations, recommends a consultation with a narrow specialist.

C. Causes leading to disruption of the composition of tears :

1. Meibomitis (meibomitis) – inflammation of the meibomian glands
Maybomite is the third most common cause of watery eyes.

The meibomian glands are found in the intermarginal rim of the eyelids (the rims of the eyelids that touch when the eyes are closed). Meibomian glands produce a special viscous secret, which is located in the surface layer of the tear.

The tear consists of 99% water, so dries quickly. The secret of the meibomian glands prevents this process.

In case of inflammation of the meibomian glands, the composition of the secretion changes or it is completely absent when the glands are clogged with inflammation products. In this case, the biochemical composition of the tear changes and the tear dries very quickly on the surface of the cornea, it becomes irritated and, as a result, increased tearing, the eyes begin to water during this process.
Treatment : eyelid margins massage (5-7 days) with anti-inflammatory ointments: “tetracycline”, “gentamicin”, “hydrocortisone”.
Treatment always has a positive result.

08/10/2021

Author, Ph.D. Oleg Getto

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  • Dry eye syndrome

If your eyes are tired, itchy or watery, and reading becomes completely impossible in the evening, you may have dry eye syndrome. It is not worth putting up with: in the long term, this unpleasant condition leads to constant irritation and even the appearance of scars on the cornea.

This is a fairly common eye problem. Many patients turn to the Maerchak Laser Eye Microsurgery Clinic with the question of how to treat the “dry eye” syndrome.

The condition is dangerous because it makes the cornea prone to infection and inflammation, reduces visual acuity. Increased dryness of the surface of the eyeball prevents laser vision correction and treatment.

The following symptoms indicate a possible dry eye syndrome:

  • burning, itching in the eyes,
  • fatigue,
  • eye pain,
  • pulsation,
  • sensation of dryness of the cornea,
  • hypersensitivity to light,
  • blurred vision,
  • feeling of sand in the eyes, the presence of a foreign body,
  • redness of the eyeballs.

Oddly enough, tearing is also a symptom of the syndrome. The fact is that the violation of the integrity of the tear film includes a compensation mechanism – more tears are produced, which, however, cannot restore the normal protective coating.

Causes

The tear film washes the eye, moisturizes its surface, removes dirt, microorganisms and dead cells. Normally, it consists of three layers:

  • The mucin component produced by the cells of the conjunctiva. Thanks to this layer, the tear film is evenly distributed over the anterior surface of the eyeball and adheres to it.
  • Aqueous layer – a product of the work of the lacrimal glands. It provides the cells of the cornea with nutrients.
  • A lipid component that coats the aqueous layer and protects it from evaporation. This fluid is produced by the meibomian glands.

Problems in any of these layers rupture the tear film and can cause the syndrome.

Two main causes of the pathological condition:

  1. violation of the ratio of components, which leads to rapid evaporation of the film;
  2. insufficient secretion of tears.

Risk factors

  • Gadgets and monitors. In front of the monitor, we blink less often, so the tear film evaporates too quickly and does not have time to renew itself.
  • Driving, prolonged concentration on something also reduce the frequency of blinking.
  • Contact lenses. You can cope with this with the help of special contact lenses.
  • Age. The syndrome is typical for people over 50 years of age, in whom tear production is reduced.
  • Menopause. Hormonal changes affect the production of fluids that bathe the eyeball.
  • Air conditioners, heaters reduce air humidity, the eye surface becomes dry faster. For the same reason, frequent flyers suffer from dry eye syndrome.
  • Smoking.
  • Systemic diseases: diabetes mellitus, thyroid disorders, lupus, rheumatoid arthritis.
  • Medications: antihistamines, antihypertensives, birth control pills, antidepressants.
  • Problems with the eyelids, such as blepharitis, which blocks the meibomian glands, disrupting the production of mucin.
  • Dry eye syndrome accompanies some operations, for example, blepharoplasty, refractive surgery. But in this case, the discomfort usually goes away on its own.

Diagnosis

Before you run to the pharmacy and buy drugs for the treatment of dry eye syndrome, it is important to understand the cause of discomfort, that is, to be examined by an ophthalmologist. In addition to examining and questioning the patient, the doctor analyzes tear production using special tests.

Depending on the cause, the intensity of symptoms, the treatment of dry eye syndrome is in three directions:

  • increase the secretion of natural tears;
  • moisten the ocular surface with artificial tears;
  • slow down the evaporation of the tear film.

If the basis of the “dry eye” is an infectious disease, treatment begins with it.

Ophthalmologists of our Clinic are attentive to the health of patients, so they tell everyone how to increase tear production and restore the natural tear film.