Watery eyes are a common issue that can stem from dryness, allergies or problems with the tear ducts. While many cases are mild, persistent or one-sided watering may signal an underlying condition that needs medical attention.

Lauren O’Neill, MD, a board-certified oculofacial and orbital surgeon, explains what causes watery eyes and when to seek care.

What causes watery eyes?

Common causes include:

• Dry eyes: The eyes produce extra tears to make up for dryness or irritation.
• Allergies: These may include seasonal allergies, pet dander, new skincare or makeup products, or even an intolerance to prescription eye drops.
• Environmental factors: Smoke, wind or pollution can irritate the eyes.
• Tear duct problems: A blocked tear duct is less common but can cause tears to overflow instead of draining properly.
• Eyelid problems: The eyelids play an integral part in directing tears towards the tear duct. Abnormal eyelid position may result in poor tear drainage. 

Do watery eyes usually affect one eye or both?

If watering affects both eyes, it’s often caused by dryness or allergies. When it’s constant in only one eye, it may point to a blocked tear duct or an issue with the eyelids. 

“In those cases, it raises suspicion that something’s wrong with the drainage system,” Dr. O’Neill says.

What does a blocked tear duct look like?

A blocked tear duct is often painless. Tears may constantly run down the cheek instead of draining through the nose.

“People will notice clear tears spilling over throughout the day,” Dr. O’Neill explains. “It may affect one or both sides, and in some cases, patients can develop an infection in the tear sac which presents as a swollen, tender, red bump on the side of the nose.

Potential causes of blocked tear ducts include:

• Chronic sinus infections or inflammation.
• Previous facial trauma near the nose or eye.
• Prior nasal or sinus surgery.
• Radiation therapy to the area and certain chemotherapy agents.
• Rarely, tumors within the tear duct system. 

What are the treatment options for watery eyes?

Treatment depends on the cause. Many mild cases improve with at-home care, while persistent symptoms may require a doctor’s evaluation.

Treatment options include:

• Lubricating or artificial tear drops: These are often the first step for ocular surface dryness or irritation. Choose drops labeled “lubricating” rather than “redness relief,” which can worsen symptoms over time. If you need drops frequently, choose preservative-free options. Thicker drops or ointments provide longer-lasting moisture but may cause mild temporary blurriness.
• Warm compresses: Reusable eye masks with beads hold heat better than washcloths and are less likely to burn the skin or drip water.
• Eyelid scrubs: Over-the-counter eyelid wipes can remove bacteria, debris and oil buildup. A budget-friendly alternative is using diluted baby shampoo and gently washing along the lash line.
• Omega-3s or fish oil supplements: Improve tear quality and reduce dryness.
• Avoiding allergens or triggers: Common culprits include face creams, makeup, soaps, eye drops, pet dander, pollen and dust. If your eyes start watering after using a new product or being exposed to an allergen, your doctor may recommend pausing or limiting exposure to see if your symptoms improve.
• Surgery: If a tear duct obstruction is found, your doctor may recommend surgery to restore normal drainage and relieve symptoms.

Stop by either Truhlsen Eye Institute Optical Shop location to purchase eye drops, eye compresses or eyelid scrubs.

When to see a doctor

If your watery eyes are persistent, associated with pain or blurry vision, or interfere with daily life, it may be time to see an eye doctor.

“Start with your general ophthalmologist or optometrist,” Dr. O’Neill advises. “They’re typically well trained to identify the cause and can refer you to a specialist if needed.”

For suspected tear duct obstruction, your doctor may perform an irrigation test by flushing a small amount of saline through the duct to see if it drains properly. Most ophthalmologists can perform this in the office and refer you to an oculoplastic surgeon if needed.

“With an appropriate evaluation, we can usually identify the cause and help patients find lasting relief,” Dr. O’Neill says.