Which medicine given in watery eyes

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"Watery eyes" (epiphora/lacrimation) is most commonly caused by allergic conjunctivitis or viral conjunctivitis. Here is a comprehensive breakdown of the medicines used:

Medicines for Watery Eyes

1. Artificial Tears

First-line for mild symptoms
Lubricating eye drops (e.g., carboxymethylcellulose, hypromellose) help flush irritants and soothe the eye
Safe for long-term use

2. Mast Cell Stabilizers (prevent histamine release)

Used prophylactically — need a few days before full effect:

Sodium cromoglicate (Cromolyn)
Nedocromil sodium
Lodoxamide (Alomide) — suitable for short-term use
Pemirolast drops (used during the allergic season)

3. Topical Antihistamines (for symptomatic relief/exacerbations)

Emedastine
Epinastine
Levocabastine
Bepotastine

4. Dual-Action Antihistamine + Mast Cell Stabilizers (most effective)

Act rapidly and are preferred for acute exacerbations:

Olopatadine (Patanol) — very commonly used, twice daily
Ketotifen — also has mast cell-stabilizing properties
Azelastine (Optivar)

5. Combined Antihistamine + Vasoconstrictor

Antazoline + Xylometazoline — relieves redness and watering together

6. NSAIDs (Topical)

Ketorolac tromethamine (Acular)
Diclofenac eye drops — provide symptomatic relief

7. Topical Corticosteroids

Effective but rarely necessary; reserved for severe/refractory cases
Used with caution due to risk of raised intraocular pressure and cataracts

8. Oral Antihistamines (for severe/systemic symptoms)

Loratadine — non-sedating, preferred for daytime use
Diphenhydramine — sedating, useful for nighttime/sleep aid
Cetirizine, fexofenadine — other non-sedating options

Quick Reference by Severity

Severity	Treatment
Mild	Artificial tears
Moderate	Topical antihistamine or mast cell stabilizer
Acute/exacerbation	Dual-action agent (olopatadine, ketotifen)
Severe	Oral antihistamines ± topical steroids (short course)

Sources: Kanski's Clinical Ophthalmology, 10th ed. | Goldman-Cecil Medicine | Textbook of Family Medicine, 9e

Important: If watery eyes are due to a blocked tear duct, infection, or other structural cause, the treatment differs and may require surgical correction. A proper eye examination helps identify the underlying cause.

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