Watery Eyes (Epiphora) in Cats

Why Do Cats Have Watery Eyes?

Watery eyes in cats, also called epiphora, is an overflow of tears from the cat’s eyes. While cats can have other types of discharge from their eyes, such as mucus or pus, epiphora refers to tears. 

When a cat has watery eyes, one of two things is occurring. Either the cat’s eyes don’t drain their tears sufficiently, or the cat’s eyes produce excessive amounts of tears. In both scenarios, the tears spill over the lower eyelids and can be seen around the eyes or on the cat’s face, often at the middle corner near the nose.

Watery eyes are very common in cats. Most pet parents will notice that their cat has a watery eye at some point in their cat’s lifespan.

Symptoms of Watery Eyes in Cats

Common signs associated with watery eyes in cats include:

• Wetness beneath the eyes

• Staining of the fur beneath the eyes (often reddish-brown, especially in light-colored cats)

• Redness and/or swelling of the skin under eyes

• Squinting one or both eyes

• Excessive blinking

• Redness and/or swelling of the pink tissue (conjunctiva) inside the eyelids

• Changes to the color or clarity of the eye, such as redness or cloudiness

• Sneezing or discharge from the nose

• Pawing at the eyes

Causes of Watery Eyes in Cats

Epiphora occurs due to excessive tear production or insufficient tear drainage. Underlying causes include:

• Blockage of the nasolacrimal duct, which drains tears from the eyes to the nose. This duct is why your nose gets runny when you cry, and your cat has this duct, too. Blockage can be due to congenital failure of the duct to open, inflammation and debris within the duct, or tumors that block the duct.

• Specific breed conformation that causes poor drainage, such as the flat face of Persians or Himalayans

• Infections affecting the eye, such as feline herpesvirus

• Allergies

• Eye injury, such as a scratch on the cornea during a cat fight

• Corneal ulcers

• Abnormal growth of eyelashes that rub on the cornea (distichiasis and ectopic cilia)

• Eyelids that roll in (entropion)

• Eyelids that roll out (ectropion)

• Glaucoma

• Tumors in or around the eye

Why Does My Cat Only Have One Watery Eye?

It’s very common for a cat to have only one watery eye at a time. Many cats with conjunctivitis, caused by herpesvirus, only show signs in one eye. Other potential causes include an abnormal eyelash on that eye, irritation or injury to that eye, or blockage of the nasolacrimal duct on one side.

How Veterinarians Diagnose Watery Eyes in Cats

Watery eyes in cats are a symptom of an underlying condition, so your veterinarian will focus on diagnosing and managing the underlying cause. Diagnostic tests include:

• Looking into your cat’s eye with an ophthalmoscope (fundic exam).

• Measuring tear production by placing testing trips inside the lower eyelid (Schirmer tear test).

• Staining the eye with fluorescein to look for ulcers.

• Performing a Jones test, where the veterinarian examines if fluorescein placed in the eye becomes visible at the nostril, which would indicate an open nasolacrimal duct .

• Measuring the pressure in the eyes to rule out glaucoma.

• Looking under the eyelid for abnormal eyelashes, which may require sedation.

In cases where the nasolacrimal duct is newly blocked and cannot be flushed open, the veterinarian may recommend a computed tomography (CT) scan to rule out space-occupying masses that are blocking the duct as it courses from the eye to the nose.

If your cat has recurrent episodes of watery eyes, your veterinarian may test for specific infectious causes like feline herpesvirus. This involves swabbing inside the eyelids, the nose, or the back of the throat and then submitting the samples to a laboratory.

Treatment of Watery Eyes in Cats

Treatment of watery eyes in cats is geared toward managing the underlying cause of epiphora.

In cats that have epiphora due to their facial conformation, like Himalayans, management will focus on keeping the face clean. Use gentle wipes intended for pets to clean under the eyes.

For cats with eye infections, medications include topical antibiotics (such as oxytetracycline or triple antibiotic ointments intended for pets) or topical antivirals like idoxuridine. In cats with other signs of upper respiratory infection, like nasal discharge, or in cats who do not tolerate eye drops, antibiotics given by mouth such as doxycycline or azithromycin may be recommended.

Cats with eyelid abnormalities or abnormal eyelashes typically require surgery. For example, in cats with rolled-in eyelids, surgery can evert the eyelid so that eyelashes don’t rub on the cat’s cornea. In cats with ectopic cilia, the abnormal hair may be surgically removed or the hair follicle may be frozen to prevent regrowth (cryosurgery).

If the nasolacrimal duct is blocked, a small tube is sometimes placed in the opening of the duct to allow the veterinarian to flush saline through it. Flushing the duct may help to clear it. If there is an infection, the cat should be started on oral antibiotics like doxycycline. In some cases, surgery may be required for treatment.

Although tumors causing blockage of the nasolacrimal duct are relatively rare, they should be considered in a cat that has a new nasolacrimal duct blockage without evidence of infection. If your cat has a tumor, treatment options may include radiation therapy, chemotherapy, or surgery. These tumors are best managed by a veterinary oncologist.

Recovery and Management of Watery Eyes in Cats

Most causes of watery eyes in cats are manageable, and cats generally do very well. Some cats may have watery eyes long-term, but they can be managed by cleaning their face with gentle, unscented, pet-friendly wipes.

A buildup of moisture can cause an infection of the skin around the eyes. If you notice that the skin around the eyes appears irritated, consider seeking veterinary advice.

If the cause of the watery eyes is an injury or something that causes irritation, an Elizabethan collar (e-collar or cone) will likely be recommended to keep the pet from scratching at or rubbing the eye.