Tearing Newport Beach

Our eyes are dependent on a normal, consistent, and balanced tear production to maintain ocular comfort and health. Excessive tearing, or epiphora, is caused by a degeneration of the normal balance between tear production and tear drainage. This imbalance can have several potential causes related to excessive tear production, diminished tear drainage, or both.

During your consultation with Dr. Joseph, he will spend time discussing and evaluating this complex issue to create a customized plan to improve your tearing.


Surprisingly, the most common cause of excessive tearing is actually excessive dryness of the eyes. Tearing occurs as a response to the irritation and damage that accumulates due to this dryness. If you experience occasional irritation, or a sandy or gritty feeling on the eyes then you may have an element of dry eye. Also, if your tearing seems to occur at certain times of the day, in certain locations, with certain weather conditions, or with certain activities, then this may be a sign that dryness is to blame.


The eyelids a very important part of a very complex interaction of factors that determines whether or not our eyes are dry and irritated or lubricated and comfortable.

  • The Tear Film – The tears produced from our tear glands are only ⅓ of the tear film. Just as important is the oil made from glands in the eyelids called Meibomian Glands. This oil stabilizes the tear film and allows it to spread and coat the surface of the eye.
  • Inflammation – The most common reason for poorly functioning meibomian glands is inflammation of the eyelids called blepharitis. This inflammation is exceedingly common and is present in the vast majority of dry eye patients seen by Dr. Joseph. It is also poorly controlled in many of these patients which propagates their dry eye symptoms despite using lubricating eye drops consistently.
  • Eyelid Structure and Function – The degree to which the health and comfort of our eyes depends on our eyelids is evident with each blink. If you try to go an extra few seconds without blinking your eye will immediately let you know how unhappy it is. If the eyelids do not rest in the appropriate position and with the appropriate tension in relation to the eye; or if closure or blinking is abnormal or incomplete, this can lead to very severe dry eye disease and in turn severe reactive tearing.


Another common cause of excess tearing is nasolacrimal duct (tear duct) obstruction. Normally, the tears we make pass through our eyelids, through our tear drainage system and into our nose. A blockage along this pathway at any point can lead to excessive tearing. Blockages can form for many reasons and cause numerous signs and symptoms ranging from wateriness or tearing to discharge, swelling, pain and infection. A complete eye tearing examination with an oculoplastic specialist such as Dr. Joseph can determine the cause of the tearing. He is an expert in this area and is sought after for his expertise. He has also published medical articles on this topic.


If the cause of the tearing is dryness or irritation, then that specific problem needs to be addressed. If the tearing is caused by a blocked tear drainage system, then surgery is usually necessary. If the tear drainage system is partially blocked, then a minimally invasive procedure to dilate the duct can be successful. A complete nasolacrimal duct blockage is treated by a bypass surgery called dacryocystorhinostomy (DCR surgery). During a DCR surgery a new pathway is created for the tears to pass into the nose, bypassing the obstruction. A silicone stent may be placed temporarily to keep the new bypass pathway open. Many surgeons perform an external DCR, where an incision on the skin is made in between the eye and nose. In his Newport Beach surgery center, Dr. Joseph performs this surgery both from the outside with a small incision in the skin (an external DCR) and from inside the nose without a skin incision (endoscopic or internal DCR). Dr. Joseph is well versed in both procedures and has published medical articles on the topic.

If you struggle with watery eyes or tearing there may be a solution. A consultation with Dr. Joseph in his Orange County office is the first step to improving your eyes.

Click here to contact Dr. Joseph’s Newport Beach office and schedule your consultation.