What causes a scratchy, teary eye (epiphora)?

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Last updated: April 6, 2025View editorial policy

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From the Guidelines

If you have a teary, itchy eye, avoid scratching it as this can cause damage to the cornea and introduce bacteria. Instead, gently rinse your eye with clean, lukewarm water or use preservative-free artificial tears like Refresh or Systane to flush out irritants 1. If something is in your eye, blink several times to help natural tears wash it out or pull your upper eyelid over the lower one to dislodge particles. For persistent irritation, a cool compress applied for 5-10 minutes can reduce inflammation and tearing.

Key Considerations

  • Avoid scratching the eye to prevent damage and infection
  • Use preservative-free artificial tears to flush out irritants
  • Blink several times to help natural tears wash out particles
  • Apply a cool compress for 5-10 minutes to reduce inflammation

When to Seek Medical Attention

If symptoms continue for more than 24 hours, or if you experience severe pain, vision changes, or discharge, see an eye doctor immediately 1. Eyes are delicate organs with a protective tear film that can be disrupted by scratching, potentially leading to corneal abrasions or infections, so gentle treatment is always best.

From the FDA Drug Label

Use Temporarily relieves itchy eyes due to pollen, ragweed, grass, animal hair and dander. The answer to scratch teary eye is that ketotifen (OPHTH) can be used to relieve itchy eyes, which may be related to a teary eye.

  • Relief is provided for itchy eyes due to various allergens.
  • The drug label for ketotifen (OPHTH) 2 directly supports this answer.

From the Research

Scratch Teary Eye

  • Scratch teary eye can be a symptom of dry eye syndrome, which is a common condition that can be treated with over-the-counter (OTC) artificial tear drops 3.
  • Artificial tears can provide relief from dry eye symptoms, but their effectiveness can vary depending on the individual and the type of artificial tears used 3, 4.
  • Some studies have found that certain types of artificial tears, such as 0.2% polyacrylic acid-based artificial tears, may be more effective than others in treating dry eye symptoms 3.
  • However, the quality of evidence for the effectiveness of OTC artificial tears is generally low due to high risks of bias and poor reporting of outcome measures 3.
  • In addition to artificial tears, other treatments such as lipid-based nanoemulsion drops or non-lipid-based aqueous drops may also be effective in managing dry eye disease 5.
  • It is essential to identify the underlying contributors to dry eye disease, such as systemic diseases, meibomian gland dysfunction, or anatomical abnormalities, and escalate therapy accordingly 4.
  • The choice of artificial tear formulation should be based on the predominant etiological causes of dry eye disease, and consideration should be given to the specific mechanical and pharmacological roles of each ingredient composing the different formulations 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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