Itchy Eyes? Watery Eyes? What You Need to Know

As a LASIK doctor and ophthalmologist practicing in the Atlanta area, Dr. Ashraf sees many patients with common eye disorders that may or may not be serious. Often people will call the Atlanta Vision Institute or send emails, inquiring whether certain symptoms warrant a visit to an eye doctor. Two symptoms people often ask about are itchy eyes and excessive tearing.

Chances are, you too, may have itchy or overly watery eyes at times, and be concerned that there might be a serious underlying medical problem. Or, perhaps you simply find these symptoms annoying and wonder if there is an effective treatment. Either way, here’s a brief rundown on these two very common eye complaints.

Itchy Eyes

More often than not, itchy eyes (medically known as “ocular pruritus”) are caused by allergies affecting the conjunctiva (the mucous membrane lining the inside of the eyelid and covering the exposed portion of the eyeball), due to exposure to allergens such as dust mites, mold, pollen and pet dander, insect venom, certain types of food, or even particular brands of contact lens solution or eye makeup.

Itchy eyes can also be a symptom of an underlying medical condition such as vernal keratoconjunctivitis (a type of allergic conjunctivitis), dry eye syndrome, meibomian gland dysfunction (inflammation of the eyelids), or blepharitis (an infection of the eyelids, often a precursor of meibomian gland dysfunction).

Some of the symptoms associated with itchy eyes include watering of the eyes, swollen or puffy eyelids, redness in the whites of the eyes, sinus pressure, a runny or stuffy nose, wheezing, difficulty in breathing, a sore throat, and blurred vision. These symptoms vary depending on the type and severity of the underlying condition.

The good news is that almost all of the causes mentioned above can be easily managed or treated once the appropriate diagnosis is made. If the underlying condition is an allergy, there are ways to prevent or relieve the symptoms such as avoiding specific allergens, taking medication or immunotherapy. If dry eyes are causing the itchy eyes, relief may come by using over-the-counter artificial tear eye drops. If the root cause is a bacterial infection (such as blepharitis), antibiotics, anti-inflammatory medication and/or special eyelid cleansing products may be needed.

When should you see an eye doctor for itchy eyes? We generally recommend patients come in for an eye exam if their symptoms persist, are getting worse or remain after the end of allergy season, or if over-the-counter medications don’t provide enough relief. After performing an eye exam, Dr. Ashraf will be able to recommend an effective treatment regimen for whatever is causing your itchy eyes.

Tearing or Watering Eyes (Epiphora)

Tearing or watering eyes (medically known “epiphora”) is a condition in which there is an overflow of tears onto the face. Epiphora can develop at any age, but most often occurs either in the first 12 months of life or after age 60. The condition may present symptoms in just one or both eyes. Depending on the severity of symptoms, watering eyes can make daily activities such as reading and driving difficult and uncomfortable.

What causes watery eyes? The simple answer is that either the eye is producing more tears than necessary, or the tear duct that drains the tears is blocked or malfunctioning in some way.

The most common causes of watering eyes are clogged or blocked tear ducts, or ducts that are too narrow (often due to scarring) or swollen (due to inflammation). If your tear ducts are narrowed or blocked, your tears will not be able to drain and will accumulate in the tear sac and become stagnant. This can lead to an infection, in which case the eye will produce a sticky liquid, further exacerbating the problem. Infection can also lead to inflammation on the side of the nose, next to the eye.

Another common cause of watery eyes is ocular surface irritations. The eyes may be sensitive to various environmental irritants such as smog, chemical fumes, hot wind, bright lights, blowing dust or other airborne substances (such as the smell of onions). Once irritated, the eyes may produce more tears than normal as the body tries to rinse the irritant away.

Other Causes of Watery Eyes Include:

• Dry eye syndrome
• Corneal ulcers
• Conjunctivitis (pink eye)
• Blepharitis (eyelid infection)
• An injury, scratch or abrasion to the front of the eyeball or eyelid
• Foreign bodies (such as sand or dirt blowing in the eyes)
• Entropion (inward-growing eyelash)
• Ectropion (when the lower eyelid turns outwards)
• Lagophthalmos (incomplete blink mechanism)
• Aging
• Chronic Sinusitis
• Allergic conjunctivitis (allergy-causing inflammation in the front of the eye)
• Tumors affecting tear drainage

Depending on the cause of your watery eyes, sometimes the symptoms will clear up on their own. However, if they persist, you should seek medical attention. This is especially true if you also experience changes in your vision, pain in or around your eye(s), discharges or bleeding from your eye, or if you sense a foreign object in the eye.

When you come in to see Dr. Ashraf, he will conduct a thorough examination, which will include getting a full medical history and asking you questions about your symptoms and lifestyle. Once the cause of your watery eyes has been determined, a treatment plan can be developed.

Treatment options depend on what’s causing your watery eyes and the severity of your symptoms. In mild cases, Dr. Ashraf may just recommend watchful waiting – doing nothing and monitoring the progression of your symptoms. Many times, if you have a mild case of conjunctivitis, Dr. Ashraf may prefer to wait for a week or so to see if the problem resolves itself without antibiotics.

Usually, though, specific treatments will be recommended. If the watering eye is caused by dry eyes, treatment with artificial tear products, punctal occlusion, or medication may be the solution. A patient with allergic conjunctivitis may be prescribed an antihistamine or anti-allergy drops, which are effective in bringing down the inflammation. An eyelid turned outward or an eye with tear duct blockages may need to be resolved with surgery.

Still have questions? If your itchy or watery eyes have you concerned, feel free to call us any time with questions or to schedule a consultation with Dr. Ashraf. The number to call 770-622-2488. It’s true—itchy or watery eyes often resolve themselves. But if these symptoms persist or you’re in pain, it’s always best to come in for an examination. When it comes to your eyes and your vision, you simply cannot afford to take any chances.