Watery eyes are extremely common in older adults
If your eyes have started watering more as you have got older, you are far from alone. Watery eyes are extremely common in people over sixty, and in the majority of cases there is a clear and treatable explanation.
The good news is that most of the causes of age-related watery eyes can be identified and addressed once they have been properly assessed. There is rarely a need simply to tolerate the problem.
Sagging tissue disrupts normal tear drainage
As the tissues of the eyelid lose their elasticity, the lower lid can begin to sag slightly away from the eye surface, a condition called ectropion. When this happens, the punctum, the small drainage opening at the inner corner of the eyelid, moves away from the surface of the eye and can no longer collect tears efficiently.
Tears that should be draining are instead left sitting on the eye surface and overflowing on to the cheek. Even a subtle degree of eyelid laxity can be enough to impair drainage significantly, and the condition tends to worsen gradually with time.
The nasolacrimal duct becomes less efficient with age
The nasolacrimal duct, the small canal that carries tears from the inner corner of the eye down into the nose, tends to narrow with age. Partial narrowing slows drainage enough that tears build up and overflow, even when tear production is entirely normal. Complete blockage of the duct causes persistent watering, often accompanied by a sticky discharge.
This is one of the most common causes of watery eyes in older adults, and it responds well to treatment once it has been identified.
A counterintuitive but frequent cause of watering
It may seem counterintuitive, but dry eyes are one of the most common causes of watery eyes in older adults. When the tear film is poor quality or insufficient, a very common change with age, the eye surface becomes irritated. The lacrimal gland responds to this irritation with a surge of reflex tears.
These reflex tears come too fast for the drainage system to cope with, and the result is overflow watering, even though the underlying problem is dryness. This is why simply producing more tears is not the same as having a well-functioning tear film, and why people with dry eyes can paradoxically have very watery eyes.
Blinking actively pumps tears, and this becomes less efficient
Tears are not drained from the eye purely by gravity. Each time we blink, the orbicularis muscle surrounding the eye squeezes the lacrimal sac and actively pumps tears through the drainage system. This is known as the lacrimal pump mechanism.
With age, this pumping action can become less efficient, contributing to poor drainage and a persistently watery eye even when the drainage channels themselves are patent and open. The weakening of this pump is often a contributing factor rather than the sole cause of watering, but it can be significant.
Assessment is straightforward and the options are good
If your eyes have become increasingly watery, it is worth having them properly assessed rather than simply tolerating the problem. Many of the causes of age-related watery eyes are highly treatable, eyelid laxity can be corrected surgically, blocked ducts can be opened or bypassed, and dry eye can be managed with appropriate treatment.
An optometrist can provide an initial evaluation. If a more detailed assessment is needed, particularly of the drainage system or eyelid position, a referral to an ophthalmologist with a specialist interest in oculoplastics will allow a thorough assessment and discussion of the options.
Frequently asked questions
Why do my eyes water more as I get older?
There are several reasons. The eyelids lose elasticity and may sag, impairing drainage. The nasolacrimal duct tends to narrow with age. Dry eye becomes more common, causing reflex watering. And the eyelid pump mechanism that actively moves tears through the drainage system becomes less efficient. Any or all of these may contribute.
Is age-related watery eye treatable?
Yes, in most cases it is. The treatment depends on the cause: eyelid laxity can be corrected surgically, blocked tear ducts can be opened or bypassed with surgery, and dry eye can be managed with lubricating drops or other treatments. Proper assessment is the first step.
Can dry eyes cause watery eyes in older adults?
Yes. When the tear film is insufficient or poor quality, the eye surface becomes irritated, triggering a surge of reflex tears. These reflex tears can overflow on to the cheek, causing a watery eye, even though the underlying problem is dryness. This is one of the most common causes of watery eyes in older people.
Should I see a doctor about watery eyes as I age?
Yes, if it is troublesome or getting worse. Many causes of age-related watery eyes are very effectively treated. An optometrist can carry out an initial assessment, and if needed can refer you to an ophthalmologist, ideally one with a specialist interest in oculoplastics, for a more detailed evaluation.
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