What Are Watery Eyes? | Causes | Management | Treatments | Support

People diagnosed with multiple sclerosis (MS) can experience many different vision problems. One such eye problem associated with MS is watery eyes or excessive tearing.

According to the National Multiple Sclerosis Society, eye problems are often the first symptom of MS to appear in a person. However, watery eyes are less common than other eye issues associated with MS, like optic neuritis, as well as those sometimes confused with MS, like neuromyelitis optica (NMO). (Both optic neuritis — optic nerve damage — and NMO — an autoimmune disorder — can lead to eye pain and vision troubles.) That said, watery eyes can be caused by health complications related to MS or as the side effects of some MS treatments.

Having watery eyes is not vision-threatening, but it can lead to blurred vision, eye discomfort, infection, inflammation, and even skin irritation. In this article, you will learn more about causes, symptoms, and ways to manage watery eyes — and when it’s time to talk to your doctor about treatment options.

What Are Watery Eyes?

Watery eyes occur when one or both eyes tear constantly or in excessive amounts. The causes behind watery eyes can include exposure to irritants, eye infections, blocked tear ducts, or even a structural problem, like sagging eyelids. Watery eyes can also result from a secondary condition, such as dry eyes.

Watery eyes can happen at any age, but the condition is most often seen in infants and older adults.

Symptoms Related To Watery Eyes

When a person’s eyes are watery, they may experience symptoms like tears that well up in their eyes, run down their faces, and/or cause blurred vision.

Seek immediate medical attention — and contact your ophthalmologist — if your watery eyes interfere with your daily activities or cause the following visual symptoms:

• Eye pain
• Full or partial loss of vision (scotoma)
• Pain in and/or around your eyes
• Swollen eyes
• Bump on the eye
• Sensation of sand or lint in the eye or eyelid
• Double vision (diplopia)
• Uncontrolled eye movement (nystagmus)

What Causes Watery Eyes?

Watery eyes are a symptom of an underlying problem. Factors and conditions that can lead to watery eyes include:

• Dry eye syndrome
• Allergies
• Common cold or sinus problems
• Weather conditions
• Eye infections
• Blocked tear ducts
• Eye injuries
• Particles stuck in the eye (or under the eyelid)
• Tear drainage system problems
• Sagging eyelids

Vision Problems Related to MS

It is important to note that watery eyes are not an outright symptom of MS. Rather, watery eyes are a symptom of another underlying medical condition, one that may or may not be related to someone's MS. More research is needed to further explore this relationship.

Multiple sclerosis affects the nervous system by attacking the myelin that protects the nerve fibers throughout the central nervous system (CNS), including the brain, brainstem, and spinal cord. The process of demyelination results in lesions (scarring) throughout the CNS that disrupts messages between the brain and the body. This interference leads to many health complications.

Multiple sclerosis can lead to insufficient tear production, and that in turn can cause dry eyes. Dry eye syndrome can also lead to watery eyes. In dry eye syndrome, there is an imbalance of the lipid (oil) that makes up a person’s tears. Without proper lubrication, the eyes dry out and become irritated and uncomfortable. This signals the lacrimal gland to produce tears. However, because the eyes do not get proper lubrication, the lacrimal glands don’t stop making tears. That excess overloads the tear drainage system.

Side Effects of MS Medications

Certain immunosuppressants used as disease-modifying therapies (DMTs) for MS may cause watery eyes in some people. Dimethyl fumarate (Tecfidera) and Interferon beta 1b (Betaseron) are both associated with watery eyes.

Members taking these medications have discussed having watery eyes that don’t stem from outside factors. “I have been on Betaseron for over four years, and I get watery eyes often,” said one member. “I’m on my third day of Tecfidera, my eyes have been burning and getting watery,” said another. Some members shared that their side effects of immunosuppressive drugs resolved on their own. “I’ve been on Tecfidera for almost four years. In the beginning, my watery eyes were mild and went away within a day or two. I have had no problem since,” they wrote.

Other Common Causes

Other common causes of watery eyes, including some inflammatory diseases and diabetes, may be more prevalent in people with MS.

Managing Watery Eyes at Home

Depending on the cause, watery eyes may clear up on their own. Self-care measures at home can help soothe watery eyes, particularly if the cause is inflammation or dry eyes.

Try Changing Your Diet

If you are currently taking Tecfidera, having a diet that contains healthy fats may help with side effects. Some members have also found that increasing their daily protein intake helped improve their watery eyes. One member wrote, “I try to have 8 to 130 grams of protein a day while taking Tecfidera. My watery eyes have gone away. All I have is a runny nose.”

Apply a Warm Compress

Applying a warm towel or compress over the eyes several times throughout the day can help with unblock tear ducts and stimulate more oil production.

Treatments for Watery Eyes

For many people, watery eyes may clear up on their own without treatment. However, if your doctor recommends treatment, your plan will depend on the underlying cause of your watery eyes.

Artificial Tears

If having a bout of dry eyes causes your eyes to water, oil-based over-the-counter lubricating eye drops may help improve your symptoms. If you have eye irritation or dry eye syndrome, your doctor may treat the problem with so-called synthetic (artificial) tears. Or they may prescribe eye drops that contain corticosteroids (steroids) to reduce inflammation.

Some common ingredients in eye drops, specifically those that treat glaucoma — echothiophate iodide and pilocarpine — actually increase the risk of watery eyes. Before you try any new medication, even if it’s available over-the-counter, get it cleared by your doctor.

Antibiotics

If your watery eyes are caused by an infection or eye injury, your doctor may recommend a course of antibiotics to treat your condition.

Allergy Medications

Treating allergies that make your eyes watery can significantly improve symptoms. Talk to your doctor about over-the-counter or prescription allergy medications that are right for you.

Removing Foreign Objects

If you happen to have something lodged in your eye or eyelid, it is very important that your doctor removes it. Do not attempt to remove foreign objects (even particles) yourself or without the help of a licensed health care provider.

Eye Surgery

If a blocked tear duct is found to cause your watery eyes, flushing them with saline or opening them with a small probe may be necessary. If you have large-scale blockage, your doctor may resort to surgery to open your tear ducts. If your eye watering stems from sagging eyelids, eyelid repair surgery may be the solution.

Get Support

By joining MyMSTeam, the social network and online support group for those living with multiple sclerosis, you gain a support group more than 185,000 members strong. Vision problems are one of the most discussed topics.

Have you experienced watery eyes related to MS? Share your experiences in the comments below or directly on MyMSTeam.