Our eyes are covered with a complex layer of tears which
is being continually replenished by glands around the
eye. This tear film is very important as it lubricates
the eye, helps fight infection and helps the eye receive
a clear image of the world. The amount of tears produced
decreases naturally as we age.
Many individuals, particularly seniors, are bothered by
excessive or too much tearing (epiphora). This annoying
condition, in which tears may continually run onto the
cheek, is commonly caused by a blockage of the eye's
This "nasolacrimal system" which routinely carries tears
away, is much like the gutters of a home roof which can
back up and overflow with rainwater when a "down spout"
Another relatively common cause of excessive tearing is
due to the loss of muscle tone in the lower eyelid. This
is another typically age related problem. When the lower
eyelid becomes too "lax" or "floppy" it moves away from
the eyeball (ectropion) so that tears cannot reach the
normal "drain pipe" located on the top edge of the lower
lid. The result is that tears accumulate and flow up and
over the eyelid onto the cheek. Returning to our "home
roof" example it is the same as if the "down spout" has
detached and pulled away from the roof's gutters.
Another type of age-related lid change causes the lid to
turn inward pressing the opening of the "drain" against
the eyeball (entropion) which blocks the tears path.
A fourth possible cause of "too many tears" is
irritation of sensitive portions of the eye causing a
reflex overproduction of tears. Ironically, the cause of
this particular "too much tears" problem may actually be
due to the eye not having enough routine tear production
and becoming "too dry." In such a "dry" condition the
eye is more susceptible to irritation from the
environment (wind, forced hot air heat or air
conditioning) and responds by producing an overwhelming
amount of tears.
All of these potentially annoying problems can be
treated. The situation in which "dry eyes" are the real
culprit can be managed in various ways from the use of
artificial tears to the instillation of tiny plugs in
the eye's "drain" to keep tears from being removed. In
some cases your doctor may even recommend practical
environmental changes at home or work such as air
If the system is actually "plugged up" it can cleared
using a variety of techniques. If the lid has become too
lax and the drain is out of position (ectropian or
entropian) surgery can provide tone to the lid and
restore adequate drainage while at the same time
improving the eye's appearance. Since the eyelids are
composed of very delicate tissue such surgery is best
performed by a specialist in "oculoplastic" surgery.
It is important to mention that what is often described
as "too much tearing" or "I feel like I'm looking
through tears all the time" may actually be caused by
other problems such as cataracts. In particular,
"looking" through cataracts and seeing things appear
hazy, is often described as "looking through water" and
thought to be excess tearing interfering with vision.