Q: I have been experiencing teary eyes for the last year or so and had X-rays of my tear ducts done to see if they were blocked. They weren't. My eyes constantly tear and yellow matter oozes out of my right eye. I don't know which doctor to go to, an ophthalmologist or allergist. Can you help?
A: The increased tearing in both your eyes and the discharge in your right eye may be caused by two different conditions. First, the tears.
Tears are a complex mixture of chemicals. They contain, along with water, electrolytes (sodium, potassium, chlorine, etc.), mucous material and oils. In addition, they contain substances that help fight infections.
There are two aspects of tearing: production and distribution. Commonly, increased tear production is a response to irritation of the eye by dirt, dust, smoke and other fumes, allergies, drying wind and emotional factors.
Excess tearing can often be related to times of exposure to these irritants and the causative agent easily identified. So you may be on the right track to consider allergies as a potential cause of your tearing.
Another cause of too many tears is lack of appropriate distribution around the eye. The tears are secreted from glands under the eyelids and then are swept across by blinking. If you don't blink often enough or you have a partial blink, the tears don't adequately cover the entire eye, so a portion of the eye will dry out and give feedback to the tear glands to produce more.
Tear liquid collects in the bottom of the eye socket and drains out through holes (nasolacrimal ducts) into the back of the nose. Blockage of the one or both nasolacrimal ducts limits drainage, which results in what appears to be increased tear production.
Although X-rays can see some of the things that might cause blockage, you may wish to consider an MRI or CT scan, both of which can provide clearer and more detailed information.
The yellow discharge from your right eye suggests the possibility of a long-term bacterial infection of the lacrimal sac, called chronic dacryocystitis. Dacryocystitis is usually, but not always, due to obstruction somewhere in the nasolacrimal system and is commonly only on one side.
Antibiotics can hold down the infection causing chronic dacryocystitis, but if obstruction is the cause, relief of that obstruction is the only cure.
My advice is to first find out the cause or causes of your eye problems by working with an ophthalmologist, beginning with determining for sure that there's no blockage. After that, if allergens or other irritants are underlying factors, they can then be dealt with.
Dr. Allen Douma welcomes questions from readers. Write to Dr. Douma in care of Tribune Media Services, 435 N. Michigan Ave., Suite 1400, Chicago, Ill. 60611. His e-mail address is DRFamily@aol.com.