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Over tearing eyes
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Over tearing eyes

I have had overtearing eyes for the past 8 months now. I went to 4 opthalmologists thus far but no relief is in sight. I am 49 yrs. old and have had chronic belpharitis. But the tearing was never this bad. My opthalmologists tried flushing the tear ducts in both the eyes (twice) and that din't help, i.e., the water flow was fine. I had MRI of the ye sockets as one opthalmologist was suspecting thyroid eye disease but the MRI showed no inflamation (inflammation) of the orbits. He put me on Pretnazone (sp?) and it helped for a couple of weeks and then the problem started all over again, not to mention the side effects of the steroids (water retention in the legs, super hunger etc. etc.). I went to an endocrynologist with all sorts
of thyroid blood workup and all the blood tests came back normal and the endocrynologist checked me out and said i had no thyroid related problems. So,
I am back to square A, where I started, continual over tearing. Righ tnow, I am
using Tobradex ointment every night before sleeping and just started Patanol
twice a day. These are left over medications from my previous visits to various
opthalmologists.

I very much appreciate any help that you can render in this context.

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Tearing can be thought of as a 'plumbing' problem. Either the tears are being produced too fast for a normal tear drainage mechanism to carry away (like water in the streets during a cloud-burst), or the tears are produced at a normal rate but the draining mechanism is partially or completely blocked (like when a drain blocks up on a sink/stool) or both.

It's not a good idea to be on Tobradex for long as it's a steroid and has side effects that can be severe like when it's taken orally.

I would investigate the tear ducts by seeing an ophthalmologist (Eye MD) that specializes in oculo-plastic surgery and determine that your tear drainage system is working. If it not then I would work with the doctor to get the drains working. It is unusual for the tear draining system in BOTH eyes to plug up at once.

If the tear drainage mechanism is normal then I would see a specialist in external eye disease-cornea specialist and concentrate on excluding 'dysfunctional tear syndrome' (poor quality tears). I think you would be a good candidate to try a 2-3 months of Restasis a prescription eye drop that improves tear quality and decreases inflammation on the surface of the eye.

Good luck. Some things are much harder than others to diagnosis and fix. Upsets physicians must as much as patients.

JCH MD Physician & Surgeon  Eye MD
1 Comment
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Avatar_n_tn
Hi, thanks very much for answering my question about over tearing eyes I have had for the past 8+ months. I am now trying Restasis since yesterday. It seems to help. I have two questions: (1) The tearing seems to increase when i use the computer (looking at the monitor even for a short time), how should I deal with this. My job requires constant use of the computer and i use it even after work.
(2) How long should I should be on Restasis. I got the medication from my eye doctor, who told me that i may have to be on it for ever!!!

Much appreciate your response.
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Avatar_dr_m_tn
Restasis works by a totally different mechanism that artifical tears. Over a period of 6-8 weeks it reduces inflammation on the surface of the eye and improves the quality of the tears. Hence a trial of Restasis is 6-8 weeks. If it helps (and its great for moderate or severe dry eyes) you must stay on it indefinetly one drop both eyes twice/day (some people can get by with one drop/once day).  The most common side effect is stinging and burning and that is common. It usually goes away in 2-3 weeks. If its a big problem your ophthalmologist can prescribe a mild steroid eye drops to take for a couple of weeks while your eye gets use to Restasis. Restasis is a very safe medication.

When you watch TV, use a computer, read, watch a movie or do sustained close tasks (sew for example) your blink rate goes down and the eye drys out and waters, hurts, stings, turns red etc.

When you use your computer: don't have any air blowing on you (fan, AC, heat vent), put a good artifical tear in your eye prior to using the computer, each 10-15 minutes look away from the computer screen, focus on something far away (look out the window) blink three or four times then resume your computer work. Be sure if you need glasses for near or intermediate distances that you wear them.  Vary your working distance to the most comfortable, adjust your font size and screen brightness to the most comfortable.

Good luck, stick with the Restasis.

JCH MD Eye Physician & Surgeon
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