Why has my eye been watering everyday for the past 2 months?

[wateryeyes]

Let me start by saying I do have Rheumatoid Arthritis, which affects my immune system. Since the end of May my right eye has watered everyday. I had my eyes checked a couple of weeks ago and the Dr. said he couldn't see anything that was wrong, and didn't believe it to be a blocked tear duct. He thought I had dry eyes and gave me some sample drops to use but they just make my eyes more watery and don't help. The only drops that have semi helped are Visine Allergy drops, I put a few drops in my eye and that helps stop the water production in the inside corner, but the outside corner continues to water where I have to keep a tissue up against my eye constantly.

This isn't allergies, and my rheumatologist said autoimmune issues will cause dry eyes, but aren't watery eyes the cause of dry eyes?  I'm so confused. A dab of Vaseline on the outer corner of the eye helps with the dryness and "leaking", but does anyone know of a potential reason?

I've seen an eye doctor, I've talked to my rheumatologist, and they can't seem to give me an answer.

[LifeLongLearner88]

Hi! I am a scribe for a cornea doctor....by no means a doctor myself... but we deal with dry eyes and watery eyes all the time. You should go to a good cornea doctor or comprehensive eye doctor. Watery eyes are commonly caused by dry eyes (counter intuitive I know), but you could have a blocked tear duct causing it as well. There is no way to know your tear duct is not blocked unless they irrigate your tear ducts. There is also something called conjunctivochalasis that can cause watering too.

PS Visine is really not good for your eyes at all... Many of their products have a medication that constricts the blood vessels in your eye to make them LOOK better (less red) but your eyes need the blood from those vessels. Maybe use Refresh or Systane products? :)

[John C Hagan III, MD, FACS, FAAO]

Visine Dry Eye forumula is okay.   Thanks for your comments

[wateryeyes]

I was actually going to pick up Systane tomorrow.  Thanks for the advice, a comprehensive eye doctor may be what I am needing to do.  I have wondered if it was a blocked tear duct...

[John C Hagan III, MD, FACS, FAAO]

Blocked tear ducts are relatively rare compared to OSD as cause of watering.  Blocked tear ducts are much more likely when its one eye, always water, history of facial fractures or nose surgery.  Almost never both eyes blocked tear ducts unless massive facial trauma.

[John C Hagan III, MD, FACS, FAAO]

It's very important your "eye doctor" is an Eye MD ophthalmologist and not a non-MD optometrist.  75% of patients with rheumatoid arthritis (RA) have eye problems. Some can be very severe including inflammation in the eye (uveitis, iritis) or severe inflammation of white eye ball wall (scleritis).     "Dry Eye" is not a medical diagnosis. It is in common use and will never go away.  Eye MDs call your problem "Ocular Surface Disorder" (OSD)   There are two types:   aqueous deficiency where there are no tears  and lipid deficiency in which there are poor quality tears and the eye waters all the time. People lump these two together so on the latter you understand the confusion of "dry eyes" when they water.  Doctors us dry eyes because no one understands ocular surface disorder.    In some RA patients the OSD is severe and is associated with dry mouth. This can be Sjorgren's Syndrome which can affect the rest of the body. You should ask your rheumatologist about testing your for Sjorgren's Syndrome.  B&L has a new blood test that can often detect SS early.  Go on my homepage (click on the active link in blue JohnHaganMD.  Look through the posts to find treatment of dry eyes. Read it.  This is on ongoing problem, gets worse with time, requires daily treatment and you may need Restasis somewhere down the line.

[John C Hagan III, MD, FACS, FAAO]

Link to Dry Eye Info:   https://www.medhelp.org/user_journals/show/2321596/2018-General-Information-on-Dry-Eyes-Now-known-as-Ocular-Surface-Disorder

[wateryeyes]

Thank you Dr. Hagan, this is great information.  Much appreciated!

[wateryeyes]

Dr. Hagan, what are your thoughts on Plaquenil? My RA doctor wants to move me from Lefleunominde to Plaquenil due to immune system damage, but have read a great deal about retina damage caused by Plaquenil and folks losing their vision. I have seen an Opthamologist for the watery eye and I've been on an antibiotic ointment since Aug. 3rd, but it's still watering.  I am going back to see him again on Sept. 7th to have it rechecked in addition to checking my eyes before starting Plaquenil.

Would you recommend Plaquenil with someone like myself that very well may have Sjorgrens?  My RA doctor says a biopsy is the sure way to determine if that's what I have, but I've had the watery eye since the end of May and clogged salivary gland for over a year.  I'm probably going to skip the biopsy since it can't be cured, but just wanted your thoughts.

[JohnHaganMD]

I take care of literally hundreds and hundreds of patients that are on plaquanil.  The incidence of plaq caused macular damage is far far less than 1%, is related to how long you have been on the medicine. (Rarely ever damage if less than 5 years) and most likely to occur in small body weight people taking high doses (greater than 400 mgm/day).  Supersize Americans get some protection by their high incidence of obesity.  Most diseases that require Plaq are associated with higher incidence of ocular surface disease (called dry eye by public).   Many need Restasis. There is a new high dose restasis just approved by FDA (Cequa. Sun Pharmaceuticals). Xiidra is crazy expensive.

[wateryeyes]

Thank you, that is what I have read is that damage mainly shows after being on it for a lengthy amount of time.  I appreciate your quick response.

[JohnHaganMD]

If you need it, you need it.  Thousands of people bleed to death annually from aspirin so nothing is without risk including not taking it.