4 Things an Ophthalmologist Looks for During a Tearing Evaluation

If your eyes constantly tear up or feel watery throughout the day, you might assume it’s just allergies or irritation. However, significant tearing can be a sign of an underlying issue with your tear drainage system.

A proper evaluation by an ophthalmologist can help pinpoint the exact cause and guide appropriate treatment. At Ophthalmic Plastic & Cosmetic Surgery, Dr. John B. Holds and his team bring extensive experience in assessing and treating tearing problems. With decades of combined work in oculoplastic surgery, they combine medical expertise with a compassionate, patient-first approach.

This blog breaks down four key things an ophthalmologist looks for during a tearing evaluation.

1. Eyelid Position and Function

The position of your eyelids plays a crucial role in how your tears drain. During your exam, your ophthalmologist will check to see if the lower eyelid is turned inward (entropion) or outward (ectropion). Either condition can disrupt tear drainage, allowing tears to collect and overflow. Eyelid laxity, or loose eyelid support, is another contributing factor they may consider.

2. Tear Duct Obstruction

Blocked tear ducts are a common reason for watery eyes. Your doctor may perform a gentle irrigation test to determine if tears can flow through the nasolacrimal duct — the pathway that drains tears from the eyes into the nose. If there’s a blockage, they may recommend imaging or further testing to identify the extent of the obstruction.

3. Tear Film and Ocular Surface Health

Not all tearing is due to drainage issues. Sometimes, dry eyes trigger reflex tearing, where your eyes overproduce watery tears to compensate for dryness. Your provider will consider the tear film quality and check for signs of dryness or ocular surface inflammation. Addressing dryness can sometimes reduce excessive tearing.

4. Previous Surgeries or Trauma

Scar tissue or anatomical changes from previous surgeries or facial trauma can interfere with the tear drainage system. Your provider will consider your history and look for any structural abnormalities that may be contributing to the problem.

Schedule a Tearing Evaluation in St. Louis, MO

If you’re experiencing chronic tearing, don’t ignore it. An ophthalmologist can assess the situation, identify the cause, and recommend long-lasting solutions. Call Ophthalmic Plastic & Cosmetic Surgery at 314-567-3567 to schedule an evaluation at our St. Louis, St. Peters, or Arnold, MO, locations.