Understanding crocodile tears after facial palsy

Crying while eating?

If you've had facial palsy and now find that one of your eyes waters when you eat, drink, or even think about food — you're not alone. This puzzling symptom is called Crocodile Tears Syndrome, and it's a known but unusual side effect of facial nerve recovery.

Here's what it means and what you can do about it.

What is crocodile tears syndrome?

Crocodile Tears Syndrome (also called gustatory lacrimation) is a condition where your eye produces tears when you're eating, even though you're not feeling emotional. It usually affects only one eye — the same side where you had facial palsy.

The name comes from an old myth that crocodiles weep while eating their prey. In your case, the “crying” is real — but caused by the way your nerve has healed.

Why does it happen after facial palsy?

One of the facial nerve’s roles is to carry special nerve fibres that stimulate some of the salivary glands to make saliva. When you experience Bell’s palsy or another type of facial nerve injury, the facial nerve stops working properly. Over time, it regrows and reconnects — but sometimes it takes the wrong path.

Instead of connecting only to your salivary glands (to make saliva when you eat), the nerve also sends signals to your tear (lacrimal) gland. So every time your body gets ready to eat — and produce saliva — it accidentally triggers your tear gland too, leading to eye watering.

This is a type of "miswiring" of the facial nerve that happens during healing.

Common signs of Crocodile Tears Syndrome

If you have facial palsy and:

• Your eye tears when eating or drinking
• It always happens on the same side as your facial palsy
• It started weeks or months after the facial palsy began to improve

...then you may have Crocodile Tears Syndrome.
It's more common than people think, especially in the months following nerve recovery.

Is it dangerous?

No — it’s not harmful to your eye or vision, but it can be:

• Annoying or socially embarrassing
• Confused with emotional crying
• Misunderstood, especially in public or during meals

Fortunately, it’s treatable.

What can be done?

Botulinum Toxin (Botox) injections

• The most common treatment.
• A small amount of botulinum toxin is injected into your tear gland.
• This reduces the tear response triggered by eating.
• The effect lasts 3 to 6 months and can be repeated.

Eye drops

• Some drops can reduce tear production, though this option is less commonly used.

Surgery (for rare, severe cases)

• If symptoms are very troublesome and long-lasting, surgery to disconnect or reroute the misfiring nerve fibres may be considered.
• This is rarely needed and should be done by a specialist eye surgeon.

Will it go away on its own?

Sometimes, crocodile tears reduce over time as the nerve continues to heal. But for many patients, the miswiring remains — especially if it starts several months after the facial palsy.

If it becomes bothersome, you don’t have to just live with it — help is available.