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Watery eyes and runny nose: Is it allergies?

Created date

July 20th, 2015

A common problem later in life is a runny nose, watery eyes, or both. Either seems like a minor problem, but they can certainly be bothersome.

“People often think they have allergies when these symptoms alone occur,” says Princess Ogbogu, M.D., director of allergy and immunology at the Ohio State University Wexner Medical Center in Columbus, Ohio. “Seniors, however, are unlikely to develop new allergies late in life.” 

It’s probably not a cold

If you have a long-term runny, stuffy, or congested nose with no other symptoms, you may have nonallergic rhinitis. Studies show that about 40% of seniors have this problem.

“Rhinitis in seniors can be due in part to age-related changes in anatomy,” Ogbogu says. “It may also be the type called vasomotor rhinitis, which can be related to triggers, including environmental irritants, cold air, hormonal changes, spicy foods, or medications—especially blood pressure medications.”

Narrowing of the airway due to structural changes or polyps may produce feelings of congestion. “Chronic infections can also cause rhinitis, and although it is very rare, thin watery mucous may be a sign of a cerebrospinal fluid leak, especially if you have had recent surgery,” Ogbogu says. 

Living with rhinitis

Anyone with rhinitis should first see their primary doctor in order to determine if an underlying cause can be treated. You might need an adjustment to your current medication regimen or a referral to a specialist such as an otolaryngologist or allergy specialist. “You may be able to avoid a lot of unnecessary testing if you choose a board-certified allergy and immunology physician,” Ogbogu says.

Treating nonallergic rhinitis includes avoiding triggers, and for some people, that may be sufficient to manage the problem. Others may need a prescription nasal spray targeted to treat the type of rhinitis—either to relieve congestion or an anti-drip formulation. Seniors should ask their doctor before trying over-the-counter drugs and sprays (especially antihistamines and decongestants) as these can have serious side effects or worsen symptoms.

Saline nasal sprays, on the other hand, are generally safe, and nasal rinses are another good option. “Rinses can be very effective,” Ogbogu says. “You can purchase specially designed kits at stores, but be sure to always use distilled water and clean the equipment thoroughly after use.”

Other tips to manage rhinitis: Use a humidifier, drink plenty of water, and gently blow your nose intermittently.

Too many tears

Like rhinitis, having watery eyes is common among seniors. This condition, also called epiphora, is usually related to what seems like the opposite problem. “The most frequent reason seniors experience watery eyes is chronic dry eye disease,” says William Trattler, M.D., volunteer faculty at Florida International University’s Herbert Wertheim College of Medicine in Miami, Fla. “Seniors may not feel as if their eyes are dry because the cornea tends to get less sensitive with age,” Trattler explains. “The excessive tears occur because the eye is compensating for the dryness.”

So with all that moisture, how can your eyes still be dry? “The very watery tears that your eye secretes are lacking the proper components to truly moisten your eye’s structures,” Trattler says. “Tears should also contain protein, fats, enzymes, and other compounds.”

Treatment for dry eyes involves improving the quality of your tears. “Cyclosporine eye drops [brand name Restasis] can reduce inflammation and help improve dry eye disease. Studies also suggest that fish oil can help,” Trattler says, “but seniors should check with their doctor before taking supplements.”

According to Trattler, most people get relief from cyclosporine, but some people may still need to use over-the-counter artificial tears. If nothing else works, plugs can be placed into your tear ducts.

If your eyes suddenly become watery, call your doctor because you may have an infection, blocked tear duct, foreign body, or an eye injury.

Why seniors don’t usually develop allergies

While it can be a problem if certain organs or systems of your body become less efficient with age, when it comes to allergies, a weaker immune system is doing you a favor. “Your immunity becomes less robust,” Ogbogu explains. “It doesn’t produce antibodies as readily, so you are less likely to have a reaction to an allergen such as pollen, pet dander, or dust.”

If you’ve had environmental allergies for most of your life, you may even notice your symptoms abate as the years go on.