eye disorders
Watery Eyes
Evaluation of Watery Eyes
Not every case of watery eyes requires evaluation by a doctor. The following information can help people decide when a doctor's evaluation is needed and help them know what to expect during the evaluation. In people with watery eyes, certain symptoms and characteristics are cause for concern. They include Repeated, unexplained episodes of red watery eyes A hard mass in or near the tear duct People with warning signs should see a doctor within a week or so. Other people who are bothered by watery eyes should see a doctor when it is convenient, but typically a delay of several weeks is not harmful. Doctors first ask questions about the person's symptoms and medical history. Doctors then do a physical examination. What they find during the history and physical examination often suggests the cause of the watery eyes and the tests that may need to be done (see table). Doctors ask whether the person has Itching, a runny nose, or sneezing (especially after being exposed to a potential allergen) Eye irritation, redness, or pain Pain or discomfort with swelling or redness near the inner corner of the eye Other symptoms (for example, headache, cough, fever, or rash) Had injuries, infections, burns, radiation therapy, or surgical procedures involving the eyes, nose, or sinuses Taken a medication that may cause watery eyes (such as chemotherapy medications or eye drops containingechothiophate,epinephrine, orpilocarpine) Doctors then do a physical examination. The physical examination focuses on the face, particularly the eyes and nose. Doctors look for tears running down the cheek, which suggests blockage along the tear drainage pathway. However, signs of a specific cause may be absent. Doctors examine the eyelids, the puncta, and the area at the inner corners of the eyes. They also examine the surface of the eye with a What Is a Slit Lamp? to examine the eye under high magnification. The nose is examined for congestion, blockages, pus, discharge, and bleeding. Doctors can usually determine the cause based on the results of the history and physical examination. Testing is often unnecessary. If testing is needed, the person usually is referred to an ophthalmologist (a medical doctor who specializes in the evaluation and treatment—surgical and nonsurgical—of eye disorders). Some tests are done in the ophthalmologist's office. Doctors may insert a small probe into the punctum and sometimes the canaliculus to try to detect blockage. They may also gently flush fluid through the canaliculus to see whether the fluid drains into the nose as it should. Imaging tests and procedures (for example, imaging of the tear ducts, computed tomography [CT] of the face and orbits, or examination of the inside of the nose with a flexible viewing tube [nasal endoscopy]) are sometimes done. 