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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3343
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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I am seeing an opthalmologist and an opthalmic plastic surgeon

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I am seeing an opthalmologist and an opthalmic plastic surgeon because excessive tearing on a fairly regular basis. Dry eye, trauma, and blockages have been ruled out. Apparently my eyes just produce too many tears too fast for them to drain properly. The opthalmic plastic surgeon has suggested a bilateral lower lid one snip, but I don't see this procedure recommended in the internet research I've done. This procedure is apparently for tightening sagging lower eye lid which is not my problem. The only procedure I have seen suggested in websites is a dacryocystorhinostomy but that's to relieve a blockage which, as I said earlier, has been ruled out. If my "system" simply produces too many tears to drain, would in deed either of these 2 procedures relieve the problem? Can you suggest any remedies?

Doctor DanB : Hello and thanks for your question. Are you available to chat?

I am for a while, but since I'm trying to "multi-task", it may take several minutes to respond. We can do what we can.


I will check back later but I have to shut down at 10:30 ET


I'm here.

Doctor DanB : Thanks. I think what the one-snip procedure they are referring to us opening the punctum or the drainage hole in the eyelid to help the tears drain better (in other words making a bigger opening for drainage)

But I was told that my punctum weren't clogged. He was able to shoot saline through my tear ducts and I felt it in the back of my throat. He said that proves there's no blockage.

Doctor DanB : Yes, while that may be true, if your punctum is on the smallish side, it can still inhibit the drainage of tears to a degree that can improve after opening the punctum up some.

OK, the OPS's nurse mentioned something like that, but I may have been visualizing what she said erroneously. One last question: I've had this tearing problem for years, but it has consistently gotten worse with each passing year until now when it has gotten dangerous (it happens when I'm driving, cycling, skiing, etc). How does the puncta get smaller and smaller over time if they're not getting blocked?

Doctor DanB : As we age the skin changes and can contract around openings like this. But you also may be making more tears as you age as well.

Well, thank you very much. You've been very helpful.

Doctor DanB : You're welcome. Do you have any other questions about this?

Not right now, but my next appointment with the OPS is next week. A question may come to me before that. If so, I'll look you up. ;-)

Doctor DanB : Sounds good. Good luck. Please help me get credit for my expertise and the time spent in answering your questions and press the ACCEPT button for this encounter; this allows part of the funds that you have deposited to the website to be released for my efforts to assist you. This does not end our conversation, however-we can continue to discuss any of your concerns without further charges until you are satisfied.Any positive feedback and/or bonus you may feel prompted to provide would be welcomed and is appreciated. Thanks for your inquiry!My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor.
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