As a Consultant Ophthalmic and Oculoplastic Surgeon, Miss Hawkes has extensive experience and uncompromised expertise in understanding all aspects of the eye from surgical procedures, infections and disease through to vision and crying.
Miss Hawkes explains what causes us to make tears, the three different types of tears, “Basal tears which are in our eyes all the time and lubricate and nourish the ocular surface. “Reflex tears are released in response to an irritant, such as smoke fumes or the fumes released when cutting an onion. Emotional tears are released in response to a strong emotion such as sadness, joy or pain,” she says.
The signal to produce emotional tears or ‘crying’ is under the control of our autonomic nervous system, which is responsible for our functions not consciously controlled, such as heart rate. An emotional trigger stimulates a part of the brain which sends a direct response to the lacrimal gland. This explains why we can’t control when we want to cry. Interestingly, humans are the only species thought to be able to able to produce emotional tears.
Crocodile tears is a term commonly used to describe insincere tears. (Crocodiles appear to be crying when eating their victims, looking sinister, however, these tears are likely to be basal and reflex!)
In medical terms, “crocodile tear syndrome” means something very different to insincere or sinister tears. Miss Hawkes explains that recovery from facial nerve damage such as a stroke can cause excessive watering which can be triggered by eating. Crocodile tear syndrome can be successfully treated with botulinum toxin to reduce production.
Miss Hawkes notes that there are many causes of a watering eye (epiphora), aside from crying. If you suffer from a watering eye or eyes, it is important to see an ophthalmologist with a specialist interest in oculoplastic surgery. This is because many causes of epiphora can be due to underlying systemic conditions or anatomical obstructions, both of which benefit from treatment. The ophthalmologist examination must include a slit lamp biomicroscopy examination as well as syringing of the tear duct.
Another cause of watering eye is a failure of the lacrimal pump, which is under the control of our orbicularis oculi muscle. This muscle encircles the eyelids and is also the cause for crows feet. The pump weakens over time due to ageing. This is a common cause of watering as there is an overflow of tears. A lower eyelid surgical tightening procedure can solve this problem.