Those watery eyes may not just be about crying

Presentation of dry eye can vary – it can take the form of a ‘foreign body’ sensation in the eye or a scratchy, dry, grit

ty or smarting feeling. Sometimes, a person with a dry eye will have excess tears running down the cheeks, which may seem confusing, reports Sade Oguntola

For Adijat Haruna, a 15-year-old student, her first experience of riding on a commercial motorcycle left her eyes shedding water. “I had to close my eyes after a few minutes because tears were just coming and it was very uncomfortable,” Adijat recounted.

Although, Adijat eye’s had adjusted to riding on commercial motorcycle to school every morning, watery eyes is a dilemma many people live with day in day out because their eyes are unable to maintain a healthy layer of tears leading to a state of relative dryness of the eyes. To compensate for this, there is overstimulation of the production of tears, which causes tears to flow easily.

Unfortunately, Dr Adeoti Emmanuel’s case was different. He started noticing problems with his sight while on a foreign trip to England. “I realized my eyes were dry at the airport and all through the trip on the plane, I had to close my eyes to get some comfort, while waiting till it was possible to get medications to correct the problem, he declared.

Sadly as one ages, the tear that is produced begin to lose its ability to properly lubricate the eyes. Tears consist of three layers: oily, water and mucus. If any of the three layers is decreased in quantity, quality or missing, the result is tear fluid that cannot adequately lubricate the eyes.

Nevertheless, the loss of any of the layers can be due to medications, menopause, exposure to overly dry air or wind, and other diseases. In addition, any condition that impedes the distribution or drainage of the tear film may result in dry eyes.

But dryness of the surface of the eye can lead to over-stimulation of the gland that causes production of the watery component of the tear film, which causes tears to flow easily. It can also be a part of the natural ageing process, especially in women, due to hormone fluctuations, according to Dr Oluyemi Fasina, a consultant ophthalmologist, University College Hospital (UCH), Ibadan, Oyo State.

Certainly, it is not all cases of “watery eye” that is due to eye dryness. He explained: “The tears come from special glands located around the eye and it is spread over the entire eyeballs when a person blinks. The tear drains through some ducts which are located at the medial end of the eye lids. Watery eye can result if there is an imbalance between its production and outflow.”

In addition, “people with some eye infections such as conjunctivitis (Apollo in common parlance) or who are allergic to allergens such as dust and dust mites might also experience watery eye.”

However, many things can affect the balance in tear production and outflow. “The simple one is emotions. When a person is beaten, he cries. Some people when emotionally disturbed cry. When there is any irritation of the eye surface due to things like fumes, dust and smoke, there would be excessive tears. The increase in tear production is the body’s normal reaction to reduce the irritation in the eye.”

Sometimes, a burning sensation, gritty sensation, pain, redness, blurring of vision or foreign body sensation would be a pointer to some degree of dry eye in some individuals.”

However, “dry eye syndrome is a group of diseases that make the eyes to be less moistened as it should and such patients may not really know unless they come to the hospital. What the patient would notice is that he is tearing, not knowing that the tears were actually provoked or triggered by the dryness,” stated Dr Fasina.

Can a person be diagnosed to have developed dry eye syndrome despite experiencing excess tears running down the cheeks? According to Dr Fasina, “if for any reason, the eye is not moist, the way the brain would react is to send impulse to the special glands located around the eye to produce more tears. The excessive tear production ensures that the surface of the eye remains wet, thus giving the impression that there was watery eye,” declared.

Nevertheless, watery eyes or tearing is sometimes that can also be caused by the blockage of the tear drainage system. “The blockage of the tear drainage system can occur at different levels and this can result in what the patient complains about as excessive tears in the eye or watery eyes”

Also, the act of blinking aside helping to spread tear over the eyeball, has a pumping mechanism to suck in the tears into the nasal cavity. Once the eye opens, the entrance of the tear drainage (punctum) opens and is placed on the surface of the eyeball and it sucks in the tears. By the time one blinks, the muscle contract, to force the tear down into the nasal cavity. But, if there is any problem with being able to blink properly, maybe due to cerebral palsy, this would affect tear drainage.

Also, in some elderly people due to the laxity in the muscles of eyelid, draining of tear from the surface of the eye is impaired.

In addition to an imbalance in the tear-flow system of the eye, dry eyes can be due to ageing process, especially menopause; side effects of certain medications such as antihistamines, blood pressure tablets and birth control pills; and diseases that affect the ability to make tears, such as Sjogren’s syndrome, rheumatoid arthritis, and collagen vascular diseases.

But it is possible for the eyes to go dry suddenly due to a damaged or blocked tear (lacrimal gland) duct caused by an infection, a tumor, scarring or trauma to the eye.

Though dry eyes may not be cured, there are a number of steps that can be taken to treat them based on its cause. According to Dr Fasina, where the dryness is provoked by such health problems as diabetes, systemic disease or autoimmune disease, this would have to be treated.

But by and large, many people find temporary relief with artificial tear preparations. These are eye drops that palliate the symptoms.”The artificial tear is instilled to the eyes every six hours or more depending on the severity of the dryness. It would break the cascade of dryness, excessive stimulation of glands and excessive tear production,” he explained.

One of the most important aspects for people who suffer from dry eyes is their diet. A balanced diet rich in nutrients such as vitamin A, B6, C and potassium is important for the prevention of dry eyes. In parts of the world where vitamin A deficiency is widespread, severe dry eye is a leading cause of blindness.

All of the B vitamins are important in preventing dry eyes, but vitamin B6 aids in the proper absorption of magnesium. Magnesium helps the body produce a hormone called prostaglandin E-7, which is necessary for tear production. Taking one banana a day can supply enough potassium for good eye sight.