Hard to find cause of watery eye

Dear Dr. Gott: I am a 65-year-old female in good health, other than the type 2 diabetes I’ve had since 1992. I have used insulin since 2002, and my diabetes is in good control with an A1C of 6.5.
I have had a watery eye for four months now. Initially, I threw away two tubes of mascara, thinking they may be causing my eye to be infected. The water is clear, and there is no pain in my eye. I used allergy eyedrops and took an allergy pill with an antihistamine in it. Neither helped my eye. I visited my dentist and learned I needed some dental work done on the upper right side of my mouth. I asked if this could cause my eye to water, and he didn’t think so. I later had the dental work completed, and my eye still watered.
I visited my ophthalmologist, and he gave me a thorough eye exam, including irrigation of the tear duct. The water flowed through to my throat. He could not find a reason for my eye to be watering. So I visited my family doctor, and she referred me to another ophthalmologist for a second opinion.
The second one did a thorough eye exam, including irrigating the tear duct again.
The second irrigation was VERY painful, leading me to believe that the needle was not placed in the proper position. When the doctor released the water, it ran down my cheek so the second doctor believes there may be a tear-duct blockage. She wanted to refer me to a surgeon. I don’t believe the second procedure was done correctly so I don’t wish to see a surgeon. She further suggested I use eyedrops up to four times a day and hold hot compresses to that eye twice a day. After a week, the eye is still watering.
Do you have any suggestions? Or is this just a part of the aging process and something I am going to have to live with?

Dear Reader: I certainly hope not. Tearing occurs when the body makes more tears than are lost through natural drainage or evaporation.
Obvious causes include exposure to cold, wind, allergies and infection or, as both ophthalmologists attempted to determine, a blocked tear duct. Other less common possibilities include irritation, an ingrown eyelash, dry eye, eyelid abnormalities, eyestrain and blepharitis (overgrowth of normal skin bacteria). Keep in mind that some medications such as antihistamines, diuretics, pain relievers, sleeping pills and beta-blockers might be the culprit. As we age, we commonly have dry eyes (decreased production of tears) and a relaxation of the muscles that hold the inner portion of the eyelid tightly against the eye.
Treatment will obviously depend on the cause. Blocked ducts can be repaired by creating a new channel from the sac to the inside of the nose. Narrowed (but not blocked) drainage channels can be widened with the use of a probe. Allergic conjunctivitis will respond to antihistamines. Infective conjunctivitis might ultimately require an antibiotic. Perhaps you are unknowingly on a medication that could be causing the tearing.
I cannot comment on the second irrigation treatment, but I can recommend you make an appointment with your primary-care physician so he or she can ask relevant questions, perform some simple testing, and zero in on or rule out some of the possibilities I mentioned. Good luck.

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