Watery eye treatment (treatment of epiphora (watering eye))

What is watery eye treatment?

A watery eye (epiphora) means tears overflow onto the cheek instead of draining away normally. It is common and has several possible causes, so treatment starts with finding out why the eye is watering rather than jumping straight to surgery.

Tears drain from the eye through tiny openings in the inner corners, into a tear sac, and down a duct into the nose. Watering can happen if this drainage system is blocked or narrowed, if the eyelid is turned out or in so tears cannot reach the drainage openings, or — confusingly — if the eye is actually dry or irritated and produces reflex tears.

Treatment is matched to the cause. It might be drops or treating an infection or allergy; a small procedure to flush (syringe) and probe the tear ducts; a minor eyelid operation to correct an out-turned or in-turned lid; or, for a blocked tear duct, an operation called a dacryocystorhinostomy (DCR) that makes a new channel from the tear sac into the nose. In babies, a watering eye from a blocked duct often clears on its own in the first year.

This guide explains the options so you can ask better questions. It is not personal medical advice — an eye specialist (ophthalmologist) should examine your eye and tell you which treatment, if any, you need.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

External vs endonasal DCR

Both approaches have high success rates for a blocked tear duct. The choice depends on the cause, your anatomy and the surgeon's expertise; discuss the pros and cons with your specialist.

Preparing for your surgery

• Expect the eye specialist to examine your eyelids and tear drainage and to work out the cause before recommending treatment.
• Mention any eye infections, previous eye or nose surgery, nosebleeds or sinus problems, especially if DCR is being considered.
• Tell the team about all medicines, particularly blood thinners, and any allergies including to anaesthetic.
• Ask whether your watering might actually be from a dry or irritated eye, which is treated differently.
• For surgery, arrange a lift home, time off (about 1–2 weeks for DCR) and follow fasting instructions if you are having a general anaesthetic.
• Ask whether a tube will be placed and when it would be removed.

What happens

First, an ophthalmologist examines your eye and eyelids and assesses the tear drainage, often by gently flushing (syringing) and probing the tiny tear ducts to see whether they are open. This helps pinpoint the cause.

What happens next depends on that cause. Irritation, infection or a dry eye is treated with drops, ointment or other medicine. A lid that is turned out or in is corrected with a short eyelid operation, usually under local anaesthetic. A true blockage of the tear duct is treated with a DCR, which creates a new drainage channel from the tear sac into the nose, either through a small skin cut beside the nose or through the nostril with no skin scar.

DCR is often done under local anaesthetic with sedation or under general anaesthetic and usually takes around an hour. A fine silicone tube is frequently left in place to keep the new passage open and is removed at a brief later appointment.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

The most important first step is being sure of the cause: operating on the tear duct will not help if the real problem is a dry, irritated eye or an eyelid that is out of position. For DCR, the main specific risks are nosebleed (especially with the external approach) and the new channel narrowing again so watering returns. Ask the surgeon which approach they recommend and why, their success rate, and what would happen if it did not work.

Published figures to discuss

Success and complication rates depend heavily on the cause and the exact treatment. For DCR specifically, success rates are high in published series, and the external and endonasal approaches give broadly similar results, with bleeding more common immediately after the external approach. Figures vary between studies and surgeons.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Recovery depends on the treatment. Drops or syringing need little or no recovery. Eyelid surgery and DCR involve some bruising and swelling for a week or two, with the final result judged once everything has settled and any tube is removed.

• Bruising and swelling around the eye or nose that settles over a week or two
• A blocked or slightly bloody nose for a few days after DCR
• Watering that improves gradually rather than stopping at once
• A fine tube in the corner of the eye until a later removal appointment

Aftercare

• Use any prescribed eye drops, ointment or nasal sprays exactly as directed.
• Avoid blowing your nose hard and follow advice on sneezing and nasal care after DCR.
• Use cool compresses and keep your head raised early on to ease swelling, if advised.
• Avoid strenuous activity and heavy lifting in the first week or two.
• Do not rub the eye, and keep any wound clean as instructed.
• Attend the appointment to remove a tube, if one was placed.
• Report heavy nosebleeds, spreading redness, fever or worsening pain.

• Prescribed drops, ointment or nasal sprays collected
• Lift home arranged for surgery, especially with sedation or general anaesthetic
• Time off work booked (about 1–2 weeks for DCR)
• Tube-removal appointment understood and booked, if relevant
• Cool compress materials ready
• Clinic out-of-hours contact saved
• Notes on which activities to avoid early on

Scars and how they heal

Many treatments leave no scar. An external DCR uses a small skin cut beside the nose that usually heals to a fine, discreet scar; the endonasal (through-the-nostril) approach leaves no skin scar. Eyelid operations use cuts placed in natural creases or behind the lid where they are hard to see. Some bruising around the area is normal at first.

⚠ Get urgent help if…

• A heavy nosebleed that will not stop after DCR
• Any sudden change in or loss of vision — seek help immediately
• Increasing pain, redness, heat or discharge around the eye or wound (possible infection)
• A spreading swelling or redness of the eyelid or around the eye
• A high temperature or feeling generally unwell
• Double vision or a pushed-forward, painful eye

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

A good result is a comfortable eye that no longer overflows, and no more tear-sac infections if a blockage was the problem. For a true blocked tear duct, DCR works well in most people, though watering may improve gradually and a small number need further treatment.

Results depend on getting the cause right. If watering comes from a dry or irritated eye, or an eyelid that is out of position, the correct treatment is medical or eyelid surgery — not a tear-duct operation. Your specialist should explain what to realistically expect for your particular cause.

When the right treatment is matched to the cause, relief is often long-lasting — a successful DCR usually keeps the eye draining for years. Occasionally the new channel narrows again over time and watering returns, which may need further treatment. Lid-position and dry-eye problems can also recur or change as you get older, so symptoms may need reviewing.

Combining with other procedures

Treatments are sometimes combined — for example, an eyelid-tightening procedure may be done at the same time as a DCR if both a blockage and a lax lid contribute, and dry-eye treatment may continue alongside. For a blocked duct with infection, antibiotics may be needed before surgery. Your specialist will explain if more than one problem needs treating.

Follow-up & long-term care

Follow-up checks that swelling and any wound have settled and that the eye is draining, and is when any tube is removed. If watering persists or returns, you should be reviewed, as the channel may have narrowed or another cause may be present. You will be told who to contact if you have a heavy nosebleed or signs of infection.

• Continue lubricating drops if dry-eye reflex watering is part of the picture
• Attend any planned tube-removal appointment
• Report a returning watering eye, which may mean the channel has narrowed
• Review lid position over time if eyelid laxity is a factor

Revision and secondary surgery reality

• If the new channel narrows, a repeat DCR or further procedure may be needed.
• Syringing may give only temporary relief if there is a true blockage, leading on to surgery.
• A silicone tube is removed at a later appointment and is not a permanent fixture.
• More than one problem (blockage plus a lax lid) may need treating to fully settle the watering.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

• A clear explanation of the cause and why the chosen treatment fits it
• Written advice on drops, nasal care and activity after surgery
• A booked appointment to remove any tube
• Clear emergency instructions for heavy nosebleed, infection or vision change
• A named contact and a plan if the watering returns

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• The type of treatment needed — drops, syringing, eyelid surgery or DCR
• For DCR, the surgeon's fee and whether the external or endonasal approach is used
• Anaesthetic or sedation, where used, and the theatre or facility fee
• Any silicone tubes or stents and a later appointment to remove them
• Imaging or specialist tear-drainage tests if needed
• Follow-up appointments and treatment of any complication

• The surgeon and facility fees and what is included
• Whether anaesthetic or sedation costs are included
• Any tubes or stents and the cost of the removal appointment
• Any tear-drainage tests or imaging beforehand
• Follow-up appointments included in the price
• What happens, and what it costs, if watering returns or a complication occurs

On the NHS? Treatment for a watering eye is available on the NHS when it is troublesome or causing repeated infections; private care is used mainly for speed or choice of specialist, and the cause should always be assessed first.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a surgeon safely

• Check your surgeon is on the GMC Specialist Register for this area.
• Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
• You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
• Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good surgeon will welcome every one of these.

• What is causing my watering eye, and how have you worked that out?
• Could my problem actually be a dry or irritated eye, or an eyelid position problem?
• Which treatment do you recommend, and is surgery really needed?
• If I need a DCR, would you suggest the external or endonasal approach, and why?
• What is your success rate, and what happens if the watering comes back?
• Will a tube be placed, and when would it be removed?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the surgeon who carries out my operation, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this operation not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified surgeon for watery eye treatment

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: Moorfields Eye Hospital — Epiphora (watering eye): diagnosis and treatment Moorfields Eye Hospital — Dacryocystorhinostomy (DCR) leaflet NHS (Milton Keynes) — Endoscopic DCR (surgery for a watery eye) Endoscopic versus external DCR: comparative analysis — PMC Comparison of endoscopic and external DCR for nasolacrimal duct obstruction — PMC

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.