Lacrimation: What It Means and Why Your Eyes Water

What lacrimation means

The word comes from the Latin lacrima, a tear. The lacrimal gland, tucked under the outer part of the upper eyelid, makes tears. Smaller glands in the eyelids add oil and mucus. Each blink spreads the tear film across the eye. The tears then drain through two tiny openings at the inner corners of the lids (the puncta), into the tear sac and down the nasolacrimal duct into the nose. That is why your nose runs when you cry.

There are three kinds of lacrimation:

• Basal tears: a constant, small flow that lubricates and protects the cornea.
• Reflex tears: a sudden flood triggered by irritation such as onions, smoke, wind, a foreign body or a dry surface.
• Emotional tears: crying, controlled by different brain pathways.

Doctors separate two mechanisms behind watery eyes:

Figuring out which applies is the first step in finding the right treatment. For a practical, everyday guide, see why your eyes water and how to stop it.

What causes excessive lacrimation

Dry eye (the most common cause in adults)

It sounds backwards, but dry eye is the leading cause of watery eyes in adults. When the tear film is poor quality, usually because the oil glands in the lids are blocked, the surface dries and becomes irritated. Nerves in the cornea then trigger a burst of reflex tears. These watery tears do not lubricate well, so the cycle repeats. Clues include:

• grittiness, burning or a tired feeling in the eyes
• watering that is worse with screens, reading, wind, air conditioning or heating
• vision that blurs and clears with blinking

Allergies

Allergic conjunctivitis causes itchy, red, watery eyes, usually in both eyes, often with sneezing and a runny nose. It follows a pattern: pollen season, around pets, or in dusty rooms. Itch is the key feature. If your eyes itch a lot, allergy is likely. See allergies for triggers and long-term control.

Infections

• Viral conjunctivitis: watery discharge, a pink eye, often starting in one eye and spreading to the other, sometimes after a cold. It is very contagious and settles over 1 to 3 weeks.
• Bacterial conjunctivitis: thicker yellow or green discharge with lids stuck together in the morning.
• Keratitis: an infected or inflamed cornea, causing pain, light sensitivity and blurred vision. Contact lens wearers are at highest risk, and it needs same-day care.

Irritation and injury

Smoke, chlorine, fumes, cold wind, bright sunlight, an eyelash or a speck of dust all trigger reflex lacrimation. A corneal abrasion (scratch) causes heavy watering, pain and a feeling that something is in the eye even after it is gone.

Eyelid problems

• Blepharitis: inflamed lid margins with crusting at the base of the lashes. It destabilizes the tear film.
• Ectropion: a lower lid that sags or turns outward, common with age or facial nerve weakness. Tears pool and spill because the drainage opening no longer touches the eye. See ectropion.
• Entropion and trichiasis: an inward-turning lid or misdirected lashes rub on the cornea and cause constant watering.
• Facial nerve palsy: after Bell's palsy the lid does not close or pump tears properly.

Blocked tear drainage

A narrowed or blocked tear duct causes constant watering, often in one eye, sometimes with sticky discharge. In adults it becomes more common after age 50, especially in women, and can follow chronic sinus problems, nasal surgery or facial injury. If the stagnant tears get infected, the tear sac swells into a painful red lump beside the nose. This is dacryocystitis.

Less common causes

• Thyroid eye disease: watering, grittiness and bulging eyes in people with Graves' disease.
• Cluster headache: severe pain around one eye with tearing, a red eye and a runny nostril on the same side.
• Lacrimal gland problems: inflammation or, rarely, tumors of the tear gland. See lacrimal gland disorders.
• Medicines: some chemotherapy drugs (such as docetaxel) can narrow the tear ducts. Some glaucoma drops and cholinergic drugs increase tearing.
• Rare infections: tularemia can cause a painful, watery, inflamed eye with swollen lymph nodes when bacteria enter through the eye (oculoglandular form).

Excessive lacrimation in one eye vs both eyes

Excessive lacrimation in children

In babies, a constantly watery eye from the first weeks of life is usually a congenital blocked tear duct. A thin membrane at the lower end of the duct has not opened. It affects roughly 1 in 20 babies, often with mild sticky discharge, and about 90 percent clear by the first birthday. Gentle massage over the inner corner, as your doctor shows you, can help. If it persists past 12 months, a short procedure to probe the duct usually cures it.

Rarely, watery eyes in a baby are a sign of congenital glaucoma. Warning signs are light sensitivity, a cloudy cornea and an eye that looks larger than the other. This needs an urgent eye specialist review. In older children, allergies and conjunctivitis are the usual causes.

How doctors find the cause

A primary care doctor or eye specialist will ask:

• whether one or both eyes are affected, and for how long
• whether the eyes itch, burn, hurt or feel gritty
• whether tears spill down the cheek or just make the eye look wet
• about contact lenses, allergies, thyroid disease, sinus problems, past facial injury or surgery, and medicines

Then they examine:

• the eyelids, lashes and the position of the lower lid
• the cornea and tear film with a slit lamp, often with fluorescein dye that shows scratches and dry spots
• tear drainage: a dye disappearance test, or syringing saline through the puncta. If the saline reaches your throat, the duct is open
• sometimes tear production, using a Schirmer test strip under the lower lid

Imaging of the tear duct (dacryocystography) is occasionally used before surgery.

Treatment for excessive lacrimation

The right treatment depends entirely on the cause, so it is worth finding it first.

Dry eye and reflex tearing

• Artificial tears: hyperlacrimation from dry eye often improves with regular lubricating drops, 4 or more times a day. Preservative-free drops are better if you use them often.
• Warm compresses and lid cleaning: 5 to 10 minutes of warmth, then gently cleaning the lid margins, helps blocked oil glands.
• Screen habits: blink fully, take breaks every 20 minutes, and lower the screen slightly.
• Prescription options include anti-inflammatory drops and, for blocked oil glands, in-office treatments.

Allergic watering

• Avoid triggers where you can, and rinse the eyes with cool water or artificial tears.
• Antihistamine or mast-cell stabilizer eye drops (some are sold over the counter) work faster for the eyes than tablets. Follow the label dose.
• Avoid using redness-relief drops containing vasoconstrictors for more than a few days.

Infection

Viral conjunctivitis clears on its own. Bacterial conjunctivitis may need antibiotic drops. Keratitis needs urgent specialist treatment.

Eyelid and drainage problems

• Ectropion and entropion are corrected with minor lid surgery.
• Misdirected lashes can be removed or treated.
• Adult tear duct blockage is treated with dacryocystorhinostomy (DCR), an operation that creates a new drainage path into the nose. It cures watering in most people.
• Narrowed puncta can be widened in a short office procedure.

Medicines for over-lacrimation

There is no single medicine that switches off tear production for everyone. Drops that treat the underlying cause (lubricants, allergy drops, anti-inflammatories) are the main options. In rare, severe cases of overproduction, such as "crocodile tears" after facial nerve palsy, botulinum toxin injected into the tear gland can reduce tearing.

Home care that helps

• Use preservative-free artificial tears for gritty, watery eyes.
• Wear wraparound glasses outside in wind and cold.
• Use a humidifier and point car and desk fans away from your face.
• Do not rub your eyes. Pat tears away from the outer corner toward the nose with a clean tissue.
• Remove contact lenses if your eyes are red or sore, and see an optometrist before wearing them again.

Frequently asked questions

What does lacrimation mean?

Lacrimation means the secretion of tears by the lacrimal gland. It is a normal process that keeps the eye moist and clean. In medical notes, "lacrimation" or "excessive lacrimation" usually describes watery eyes, where more tears are produced than the eye can drain.

What causes excessive lacrimation?

The most common causes are dry eye, which triggers reflex tearing, allergies, conjunctivitis and irritation from wind or smoke. Eyelid problems such as an outward-turning lower lid and a blocked tear duct are common in older adults. Pain or blurred vision suggests a corneal or deeper eye problem.

Why does only one eye water?

Excessive lacrimation in one eye usually points to a local cause: a blocked tear duct, a lid that turns outward, an eyelash or foreign body, a corneal scratch or an infection in that eye. Cluster headache causes one-sided tearing with severe pain. Persistent one-sided watering deserves an eye exam.

Can artificial tears treat excessive tearing?

Yes, when dry eye is the cause. Lubricating drops calm the dry surface so the reflex flood of tears stops. Use them regularly for a few weeks, preferably preservative-free. They will not fix watering caused by a blocked duct or a lid problem.

Why do my eyes water outside in winter?

Cold, dry, windy air irritates and dries the eye surface, which triggers reflex lacrimation. Cold also slows drainage through the tear duct. Wraparound glasses usually help. If one eye waters much more than the other, the duct on that side may be partly narrowed.

Is excessive lacrimation in children serious?

Usually not. In babies it is most often a congenital blocked tear duct, which clears on its own by 12 months in most cases. See a doctor quickly if the baby avoids light or the eye looks cloudy or enlarged, which can rarely signal glaucoma.