Why Are My Eyes Watering If They Are Dry?

What Can Cause Watery Eyes?

Tear-Film Instability and Dry Eye

When the tear film breaks apart too quickly, areas of the ocular surface may become exposed and irritated between blinks. This can trigger reflex tearing.

Patients may also notice:

• Burning or stinging

• A gritty or foreign-body sensation

• Redness

• Fluctuating or blurry vision

• Light sensitivity

• Symptoms that worsen with reading, computer use, wind or air conditioning

Meibomian Gland Dysfunction

The meibomian glands in the eyelids produce the oil layer of the tear film. When these glands become obstructed or stop producing healthy oil, tears evaporate more quickly. Meibomian gland dysfunction is a common contributor to evaporative dry eye. Even when the eyes produce plenty of watery tears, insufficient oil may prevent those tears from remaining stable on the ocular surface.

Blepharitis, Demodex and Ocular Rosacea

Inflammation and debris along the eyelid margins can irritate the ocular surface and affect meibomian gland function. Potential contributors include anterior blepharitis, Demodex blepharitis and ocular rosacea.

These conditions may cause watering along with crusting, redness, itching, swollen eyelids or irritation around the eyelashes.

Allergies

Allergic conjunctivitis can cause watery, itchy and red eyes. Dry eye and allergies can occur at the same time, and some allergy medications may contribute to ocular dryness. A careful examination helps distinguish among these overlapping conditions.

Eyelid or Ocular-Surface Abnormalities

Incomplete blinking, poor eyelid closure, eyelid malposition, loose eyelids, conjunctivochalasis and corneal irritation can interfere with the way tears spread or drain. A retained foreign body, corneal abrasion or other ocular-surface injury may also cause sudden tearing.

Tear-Drainage Problems

After tears cross the eye’s surface, they normally drain through small openings called puncta, travel through the canaliculi and lacrimal sac, and then pass through the nasolacrimal duct into the nose.

Narrowing or obstruction anywhere along this pathway can cause tears to back up and overflow. A tear-drainage problem may be more likely when:

• Tearing is persistent rather than occasional

• One eye is affected much more than the other

• Tears regularly run down the cheek

• Tearing occurs indoors as well as outdoors

• There is recurrent discharge or crusting

• Swelling or tenderness develops near the inner corner of the eye

These patterns are not diagnostic by themselves, but they can help guide the evaluation.

Why Can Watery Eyes Cause Blurry Vision?

The tear film forms the eye’s first refractive surface. When it becomes irregular or unstable, vision may fluctuate—particularly while reading, driving or using a computer.

Excess tears can also temporarily distort vision as they collect across the eye or spill over the eyelid. Blinking may briefly clear the vision before it becomes blurry again. This is why some patients with dry eye report that their vision changes from moment to moment even when their glasses prescription is correct.

How Does EnVision Determine What Is Causing the Tearing?

At EnVision Dry Eye Center, Dr. Jason Besecker evaluates the entire tear system rather than assuming that every watery eye has the same cause.

The evaluation begins with a detailed history, including:

• Whether one or both eyes are affected

• When and where the tearing occurs

• Symptoms such as burning, itching, grittiness or blurred vision

• Environmental and visual triggers

• Contact lens use

• Previous eye surgery or injury

• Current medications and medical conditions

• Previous treatments and how the eyes responded

​​​​​​​Testing and examination may include:

• High-resolution slit-lamp examination and imaging: Evaluates the eyelids, eyelashes, tear film, puncta and ocular surface.

• Meibography: Images the structure of the meibomian glands and identifies gland changes or loss.

• Noninvasive tear breakup time: Measures how long the tear film remains stable between blinks.

• Tear osmolarity: Provides information about tear-film concentration and homeostasis.

• Fluorescein staining: Helps reveal tear-film instability and areas of corneal or conjunctival damage.

• Eyelid and punctal evaluation: Identifies lid-position problems or abnormalities affecting tear distribution and drainage.

• Dilation and irrigation: May be performed when a tear-drainage obstruction is suspected to evaluate whether fluid can pass through the lacrimal system.

No single test explains every case of excessive tearing. The findings must be interpreted together to determine whether the primary problem involves tear production, evaporation, ocular-surface irritation, eyelid function, tear drainage or a combination of factors.
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How Are Watery Eyes Treated?

Treatment depends on what is causing the tearing.

When Dry Eye Is Causing Reflex Tearing

Treatment is directed at stabilizing the tear film and reducing ocular-surface irritation. Depending on the findings, this may include:

• Improving daily eyelid hygiene

• Supporting the tear film with appropriate lubricating or prescription therapies

• Managing inflammation

• Treating meibomian gland dysfunction

• Addressing incomplete blinking or environmental triggers

• Treating associated blepharitis, Demodex, allergies or ocular rosacea

• Supporting healing when the corneal or conjunctival surface has been damaged

When indicated, treatment may include in-office procedures directed at the eyelids or meibomian glands. More advanced therapies may be considered when significant ocular-surface damage or tear deficiency is present.

When Tear Drainage Is the Problem

If the tear-drainage pathway is narrowed or obstructed, treating the ocular surface alone may not completely resolve the tearing.

Some patients require further evaluation by an oculoplastic or lacrimal specialist. A clinically significant or complete nasolacrimal duct obstruction may require a surgical procedure to restore drainage.

When Several Conditions Are Involved

Excessive tearing is frequently multifactorial. A patient may have tear-film instability, eyelid inflammation and impaired drainage at the same time.

In these cases, treatment may need to address several contributing factors. Follow-up examinations help determine which symptoms are improving and whether the treatment plan needs to be adjusted.

When Should Watery Eyes Be Evaluated?

• Sudden or significant vision changes

• Moderate or severe eye pain

• Marked redness or light sensitivity

• An eye injury or chemical exposure

• Thick or pus-like discharge

• Significant swelling or tenderness near the inner corner of the eye

• Fever or rapidly worsening symptoms

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Frequently Asked Questions

Can dry eye really cause excessive tearing?

Yes. Tear-film instability and ocular-surface irritation can trigger reflex tear production. The additional watery tears may overflow without resolving the underlying tear-film imbalance.

Why do my eyes water more in wind or cold air?

Wind, cold air and low humidity can increase tear evaporation and irritate the ocular surface. The eyes may respond by producing additional reflex tears.

Can allergies and dry eye occur together?

Yes. Allergies and dry eye can overlap and produce similar symptoms. Itching is often associated with allergies, while burning, grittiness and fluctuating vision may suggest dry eye, but an examination is needed to determine the contributing factors.

Why does only one eye water?

Unequal symptoms can occur with dry eye, but persistent one-sided tearing may also raise concern for an eyelid abnormality, punctal narrowing or obstruction within the lacrimal drainage system.

Will artificial tears stop my eyes from watering?

Artificial tears may help when ocular-surface dryness is triggering reflex tearing. However, they may not address meibomian gland dysfunction, blepharitis, allergies, eyelid abnormalities or a drainage obstruction. Persistent symptoms warrant a comprehensive evaluation.

Schedule an Evaluation for Watery Eyes

Watery eyes do not always mean that the eyes are producing healthy tears. A comprehensive evaluation can determine whether the tearing is caused by dry eye, eyelid disease, allergies, impaired drainage or several contributing conditions.

Jason Besecker, OD, MS, focuses exclusively on dry eye and ocular-surface disease at EnVision Dry Eye Center in Nampa, Idaho. He uses objective diagnostic testing and a detailed clinical examination to identify the factors contributing to each patient’s symptoms and develop an individualized treatment plan.

Request a Comprehensive Dry-Eye Evaluation