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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7803
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I have watery eyes every day. I have also a nose that runs

Resolved Question:

I have watery eyes every day. I have also a nose that runs constantly with very watery fluid. sometimes just running uncontrollably.especially when I bend over.I also have when touched pain in and around my nasal bone.I have seen a consultant, who while admitting the mucus was very watery, could offer no explanation.Sometimes while at home I will walk around with a tissue stuffed up each nostril,and now my eyes are getting worse,as I have a job to read.Doctors just scratch their heads when I tell them how painful the area around my nasal bone. It seems to be the cartlidge that hurts. Can you please help.
Submitted: 2 years ago.
Category: Eye
Expert:  Dr. Rick replied 2 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

Good morning. Welcome to chat.

Customer:

have you an answer to my question

Dr. Rick :

I am glad that the ENT doc didn't find anything wrong. It is very possible that you have one of two things going on: Either you have some abnormality/infection of your lacrimal sac and/or tear drainage system or you have an issue with your tear film/anterior segment from a combination of allergies/dry eyes and blepharitis.

Dr. Rick :

There are some things you can try at home to treat a possible anterior segment issue. If this doesn't help then I'd suggest you try to get a referral to an ophthalmologist for a complete exam. Here is some information on the home treatment you can try first:

Dr. Rick :

Well It sounds like you have a couple of things going on. First is allergies, second dry eyes and third blepharitis.


 


When it comes to allergies it is almost impossible to pin down the offending agent(s) and, therefore, treatment needs to focus on controlling the symptoms. Dry eyes are very common and can be improved by a stepwise series of therapies. First, the use of natural tears 4-6+ times/day to augment your natural tear production, if this doesn’t work then you can try temporary punctal occlusion of the lower puncta, then, if needed, temporary occlusion of all 4 puncta then, if indicated, surgical ( non-reversible) closure of the puncta. The openings to your tear drainage system are called puncta and you have one opening on each lid, near your nose.


 


Blepharitis is a condition where glands in the eyelids are not functioning normally. They become plugged and instead of putting out their normal clear, oily secretions, they put out thick, toothpaste like gunk. You may not be able to see this “gunk” yourself, unless it is really bad, but it shows up clearly on slit lamp examination.


 


The best treatment for this condition daily lid scrubs combined with warm compresses. I like to use baby shampoo for lid scrubs. In the shower, place the shampoo on your index fingers, close your eyes, raise your eyebrows (to stretch the skin on your eyelids) and scrub back and forth along your eyelashes for 3 to 5 minutes. The hot water in the shower helps to soften the plugged oils in the glands while the mechanical scrubbing with your soapy fingers removes the oils.


 


Baby shampoo lid scrubs will also help to wash away allergens and stimulate tear production, thereby addressing all three of your issues. Remember, this is not an instant fix. While you are waiting for the lid scrubs to have affect you can use over the counter allergy pills such as Travist, dimetapp or Zyrtec.


 


Should your symptoms get worse, your vision become significantly affected or things just not get better in 3 weeks or so you should have a complete eye examination by your local ophthalmologist to look for other, less common, causes of your symptoms.


 


 

Dr. Rick :

Of course, an anterior segment problem such as allergies, dry eyes and blepharitis does nothing to explain the pain around your nasal bone. That is why I also placed lacrimal sac/tear drainage channel problems high on my differential diagnosis list. Since it can take some time to get in to see a specialist in the UK you may want to request a referral to an ophthalmologist from your GP at the same time that you start doing the above home treatment. If things get better you can always cancel the appointment.

Dr. Rick :

Does this make sense to you?

Dr. Rick :

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Dr. Rick :

Are you there?

Dr. Rick :

I guess that you have stepped away from your computer. We can use the Q&A system to 'text message' each other. An email will be sent to each of us every time something is posted to this thread.


 

Expert:  Dr. Rick replied 2 years ago.
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Expert:  Dr. Rick replied 2 years ago.
Let me know if there are there any other concerns or issues you would like to discuss on this topic.
Customer: replied 2 years ago.
Hi, I cannot take any over the counter medicine as I already take 4 kinds of antihistamine>I have S.L.E. with urticarial vasculitis an often end up as an emergency in A&E. with swollen throat and tongue If I have a tear duct blockage would it involve surgery? and what does that involve.That may explain the pain in my nasal bone
Expert:  Dr. Rick replied 2 years ago.
Well, you definitely have enough antihistamine medicine in your system already then :)

If the problem with the tear duct system is an infection then antibiotics are indicated, although probing and flushing of the system is usually also involved to clear out as much of the "gunk" as possible first.

To evaluate your tear drainage system sometimes a special dye is injected and then followed with imaging (either xrays or other special equipment)to see if an area of abnormality can be seen. And, yes, if indicated, surgery can be done in many cases to fix the system. This type of surgery is usually done by an oculoplastic surgeon or an ENT doctor.

Depending on your specific findings there are a number of surgical approaches. One of them is called a dacryocystorhinostomy. Here is a good web page on this procedure:

http://eyewiki.aao.org/Dacryocystorhinostomy
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7803
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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