Excessive tearing (epiphora, not dry eye)

Posted by karinm @karinm, Feb 22, 2025

I’ve had excessive tearing (epiphora) in both eyes for several months. My ophthalmologist recommended Alaway drops for allergy, which did not help. I am now seeing an oculofacial plastic surgeon, who performed irrigation and determined that everything looks ok (puncta are open, no infection, no inflammation, no duct stenosis, etc.) and that my tear ducts are open but not functional. He recommends surgery - tear duct stenting (with a general anesthetic), but says there is only a 50% (or less) chance it will help. If that is not successful, then DCR surgery (dacryocystorhinostomy - much more invasive) is the next step.

I’ve done a lot of research online about this condition, called functional epiphora, and am so discouraged to learn that is not at all well understood, and there are no defined treatments for it. I read about the importance of the orbiculari oculi muscles around the eye for tear drainage, so I am now starting strengthening exercises for those muscles.

This is a truly miserable condition which greatly affects my quality of life– blurry vision, bloodshot eyes, puffy red eyelids and skin, and skin surrounding my eyes that is inflamed and stings from the salty tears. I wouldn’t wish this on anyone, but am hoping someone has gone through this and describe what their experience and what, if anything, helped.

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Hello Karnim, I had a bout of epiphora several years ago. I saw an oculoplastic surgeon who offered treatment which I declined due to my take of the risk versus benefit. The epiphora did resolve on its own although sometimes my eyes feel wet. I was interested that your eyes feel the effects of salty tears. I'm not sure if this is a clue but my tears didn't have that effect at all.

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Profile picture for tillymack @tillymack

Hello Karnim, I had a bout of epiphora several years ago. I saw an oculoplastic surgeon who offered treatment which I declined due to my take of the risk versus benefit. The epiphora did resolve on its own although sometimes my eyes feel wet. I was interested that your eyes feel the effects of salty tears. I'm not sure if this is a clue but my tears didn't have that effect at all.

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Thanks, tillymack for responding. I'm glad to hear your epiphora went away. I hope you will answer some questions I have.
- Did you have a specific diagnosis of the cause, or was it considered "functional," like mine? (i.e. cause unknown).
- How bad was the tearing (did tears sometimes flow down onto your cheeks; did they give you blurry vision)?
- How long did you have it before it resolved? Did it resolve gradually?
- What treatment was offered that you declined?
Thank you again for writing. You are the only person I know or have hear from who has this problem.

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I never know the cause... I have a vague recollection that the treatment proposed was to re-route my tears elsewhere but this was years ago and as you know I declined. I do remember the doctor tested how patent my tear ducts were but I don't remember the verdict! I think my tears did flow down onto my cheeks but it was more occasional than constant and for that reason I wasn't keeping track of the frequency. It was probably gradual but the entire issue only lasted a month or so that I remember. I'm sure there was no inflammation or stinging involved. The tears were like tears you would experience from crying.

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Profile picture for tillymack @tillymack

I never know the cause... I have a vague recollection that the treatment proposed was to re-route my tears elsewhere but this was years ago and as you know I declined. I do remember the doctor tested how patent my tear ducts were but I don't remember the verdict! I think my tears did flow down onto my cheeks but it was more occasional than constant and for that reason I wasn't keeping track of the frequency. It was probably gradual but the entire issue only lasted a month or so that I remember. I'm sure there was no inflammation or stinging involved. The tears were like tears you would experience from crying.

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Thanks for trying to remember! I've read about the surgery that re-routs the tear ducts, and it's major, so you made a very wise decision not to do it. I'm on the fence about my stent surgery, which is scheduled for less than two weeks from now.

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I appreciate your letting me know that I made the right decision, thank you! Are you scheduled for the stent surgery? Has your tearing been constant and long lasting? Have you considered a second opinion? I only ask since you mentioned it's major!

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Hello,
I know that you asked this question over a year ago, but I have the exact same symptoms you described in your post. Have you found a solution to this problem? I'm frustrated with it and can't find a solution.
Thanks!

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Profile picture for laeapple @laeapple

Hello,
I know that you asked this question over a year ago, but I have the exact same symptoms you described in your post. Have you found a solution to this problem? I'm frustrated with it and can't find a solution.
Thanks!

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Doctor has me on Restasis 2x a day and I used Systane Complete 4x a day. It worked. I stopped the Systane but I must stay on the Restasis 2 a day.

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Profile picture for laeapple @laeapple

Hello,
I know that you asked this question over a year ago, but I have the exact same symptoms you described in your post. Have you found a solution to this problem? I'm frustrated with it and can't find a solution.
Thanks!

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@laeapple
I'm so sorry you are experiencing this. Eventually, after several months or more, the tears gradually stopped, with no help or diagnosis from 3 different neuro-opthalmologists. One thing I did, perhaps after the first month or so, was to fill an eye cup with a body-temperature sterile saline solution, hold it firmly against each eye (holding my head upright), and blink hard 8 or 10 times in the hopes of getting the solution into the corner of my eye and into the lacrimal sac, in order to stimulate the lacrimal pump mechanism to start functioning. (I was told that it was not working, but no doctor know why). I have no idea if this helped, but as I said, I did get better, and it has not come back, at least so far. One doctor gave me a prescription cream (triamcinolone, I think) to put on the sknw around my eyes (NOT in my eyes) because the skin was so inflamed from the salty tears. Have you had cataract surgery in the last 3 or 4 months? I had had that surgery done about 3 moths prior , and had read somewhere there might be a connection between that and tearing, even months later. You don't say how long you've had this. Be patient; I hope you will get better.

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Profile picture for laeapple @laeapple

Hello,
I know that you asked this question over a year ago, but I have the exact same symptoms you described in your post. Have you found a solution to this problem? I'm frustrated with it and can't find a solution.
Thanks!

Jump to this post

@laeapple
Correction: I meant three oculoplastic surgeons, not neuro-opthalmologists.

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Profile picture for mikayla @mikaylar

Doctor has me on Restasis 2x a day and I used Systane Complete 4x a day. It worked. I stopped the Systane but I must stay on the Restasis 2 a day.

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@mikaylar I have been on either Restasis or Xiidra for over a decade for dry eyes. I think it helps in general, but then I have these flare ups!
Thanks for responding!

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