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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Profile picture for karinm @karinm

@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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@karinm Thanks for the help! I too have had it for as long as 3 months, last year. Right now this flare-up has lasted 3 weeks, although it has slowed down considerably and may be almost over with. I had allergy testing yesterday to see if allergies were the cause, but I tested negative to almost every allergen or tested so low that the doctor doesn't think allergies are the cause...
All of the eye doctors I have seen can't figure it out!
Thanks for the suggestions. I appreciate it!

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Profile picture for laeapple @laeapple

@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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I just started using generic Restasis. 1/3 the price

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Profile picture for mikayla @mikaylar

I just started using generic Restasis. 1/3 the price

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@mikaylar me too! Cyclosporine I think it's called?

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