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  • Q&A with Australian Health Practitioners

    Weeping eyes

    Lately, my eyes has been weeping constantly, the right much more than the left one. The tears just build up and flow freely down my cheeks if I don't keep wiping them away. I have always been inclined to suffer from a dry mouth for a few years but have put that down to the medication “endep” which I take for chronic pain - not certain if the two could be related?
  • Image of Barry Zinn

    Barry Zinn

    Optometrist

    21

    Thanks

    I am a consulting optometrist involved with OPSM in Hornsby, Westfield Shopping Centre. . I qualified in 1982 and my focus is in primary eye ... View Profile

    The most common cause of a weeping eye is a dry eye.
    Whilst that does sound contradictory the eyes water as a result of being dry.
    This syndrome is more common in women and who are menopausal or post menopausal.
    The other possible reason is a blocked tear duct whereby the normal drainage of tears is hindered by a blockage of the tear drainage mechanism resulting in a pooloing and subsequent flowing of tears out of the eye.
    Dry eyes is a fairly chronic condition which can be alleviated by lubricating the eyes regularly with moisturising eye drops.
    A blocked tear duct can also be reversed by consulting an ophthalmologist for a relatively easy and quick procedure

  • 8

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    Simon has over 30 years experience in Optometry and Optical Dispensing and is the owner of North Lakes Optometry, an Ethical, Independent Optometry Practice providing ... View Profile

    Weeping is caused by irritating a dry eye, overproduction of tears or inadequate drainage of tears.
    Dryness may be related to a systemic condition, but a weepy eye is better than chronic pain, so don't ever stop using a medication unless your precribing doctor agrees.
    Take your weeping eyes to a reputable optometrist for evaluation.

  • 18

    Thanks

    Behavioural Optometrist with a special interest in:Binocular Vision ProblemsChildren's Learning ProblemsSports Vision EnhancementVision Improvement ProgramsPassionate about educating clients. View Profile

    To add further to the above answers: when 2 dry surfaces rub against each other the resulting irritation will cause reflex tearing, resulting in a watery eye. Many Australians may be deficient in zinc as the Australian soil lacks zinc. If you are deficient in zinc this may be the cause of the dry eyes. I would recommend before embarking on a lifetime of instilling artificial tear drops that you firstly have your zinc levels tested. If low it will take 4 to 7 weeks to normalise your zinc levels. After this time if you still experience the weeping eyes then by all means use lubricating drops.  It is also advisable to check with your optometrist for meibomian gland dysfunction. The meibomian glands are in the eyelids and secrete oils important to the integrity of your tear film. It is natural for them to function less efficiently with age.

  • 9

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    Have been in private practice for 35 years and specialise in assessing eye diseases and giving professional advice regarding these conditions. With the installation of ... View Profile

    Dry eye is detected by a series of tests,If you are positive !.
    1.Hot compresses apllied nightly
    2.Use systane balance twice daily
    3.within 2 weks a correct diagnosis will be made

  • 5

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    Optometrist, DirectorDry Eye Centre, Heathmont, VictoriaA Melbourne based clinic specialising in Dry Eye and Ocular Surface Disease. View Profile

    The four respondants to your question have all made some good points.  However, as a dry eye specialist, I thought I might just crystalize the science.  For lots more information on this topic feel free to visit our website www.dryeyecentre.com.au.

    1.  If you have persistent weeping eyes, you should forget about lubricating eye drops.  They are most unlikely to help.  The brief reasoning behind this is that historically, we believed (incorrectly) that all dry eye problems (of which weeping eyes is just one type) were mostly due to not enough watery tears.  Indeed, most of the early eyedrops including many that are still on the pharmacy shelves today, are basically replacement drops for the watery part of our tears.  That's ok if you have water deficiency!  However, the evidence now suggests that we were wrong about all that.  In fact about 85% of dry eye disease has nothing to do with insufficient watery tears! So if you're part of that 85% of people you can forget about water replacment eye drops!  Not to mention that many of these eye drops have a nasty little preservative in them called BAK (benzalkonium chloride).  This horrible preservative destabilizes the corneal surface leading to increased inflammation and guess what....more dry eye!!

    2. Let' s just say then, that you share your condition with the 15% of people that do actually have a watery tear deficiency.  Well, it would seem a little contradictory, since your tears run down your face right?  But let me explain.  I noted you said that your mouth has been dry for a few years. I find this interesting.  Here at the Dry Eye Centre, our clinic is full of patients who never realised that their dry eyes could have something to do with an underlying autoimmune problem.  Autoimmune disease is now believed to be the trigger for the other 15% of dry eye (and yes, the type where some patients derive benefit from water replacement eye drops).  If you were my patient, the first thing I'd be doing with you is giving you a list of our preferred blood tests to look for autoimmune and thyroid problems.  With a dry mouth, I'd especially be interested in Sjogren serology.  If these tests returned any positive findings, I'd be looking at a quite different managment plan for your problem.  And about the contradiction with tears running down your face?  Well, ocular surface science is complex.  However, autoimmune diseases can disrupt both the watery tear production as well as the ocular surface itself.  Therefore, it doesn't necessarily mean you have no watery tears.  However, if the ocular surface is destabilized by an autoimmune condition, there may be nothing to hold the watery tears in place. In some patients with autoimmune disease, watery tear production is also impared.  Finally, on this point, you should not worry about the prospect of autoimmune disease.  After all, if we're just talking dry eye, there's an 85% chance it's not! and the dry mouth could be due to the Endep.

    3.  Yes some medications can cause dry eye / mouth problems.  Endep can cause both, though we don't know the exact likelihood.  You should never, stop your medication without professional advice, but you could discuss this with your doctor. And yes, if there is no underlying autoimmune problem, then this could be the cause of dry mouth.

    4.  Finally, that 85% of dry eye patients I mentioned?  If they don't have a watery tear deficiency, then what do they have?  Well the tears are made up of three layers.  I've already discussed the watery part (called aqueous) and the inner layer (mucin) is not for this discussion.  However, the outer layer is an oil called "lipid" or "meibum".  This is where the problem origintes for 85% of dry eye sufferers.  The meibum arises from tiny glands on the edges of the eyelids just behind the eye lashes.  For lots of reasons these glands become blocked.  This is a problem, because the meibum is needed to sit on top of the watery aquous layer, to stop it from evaporating or running down your face.  Have you ever poured oil on water? if you have you'll know it floats! If there's no oil the water dries up (or runds down your face).  If your glands are blocked, there is a range of treatment options which we offer to unblock them and educate you in the future maintencance of them.  So if, the tears are running down your face, what about the newer generation oil replacement eyedrops like Systane Balance.  After all it's meant to replace the oils!  Well the problem is that all these eye drops are just bandaids.  For short-term use in the mildest of cases they may help, but they do not permanently alter ocular surface biochemistry in any good way, and as for those preservatives.....So the only way to deal with blocked glands is to clean them out, including the drainpipes (as one respondant suggested).  You must deal with the root cause, or in most cases the condition will progress and symptoms continue or even worsen.

    Here at the Dry Eye Centre, we use advanced diagnostic techniques to investigate the health of the whole ocular surface, taking a holistic approach, we apply the the most advanced evidence based diagnostic and treatment procedures available.

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