Low-Dose Atropine Eye Drops for Excessive Tearing (Epiphora)

Inclusion Criteria: * Adults 18 years of age or older * Symptomatic epiphora (unilateral or bilateral) with tearing requiring eyelid wiping or dabbing at least 2 times per day (Munk score ≥2) * Epiphora attributed to functional/idiopathic, gustatory, environmental, or lacrimal outflow (e.g., nasolacrimal duct obstruction, punctal stenosis) etiology * Visual acuity of 20/200 or better in at least one eye (with habitual correction or pinhole) * Willing and able to self-administer eye drops nightly for 7 days in each of two treatment periods and attend all study visits * Prior use of topical atropine permitted if at least 10 days have elapsed since the last dose Exclusion Criteria: * Clinically significant dry eye disease, or tearing judged to be a reflex response to ocular surface disease, blepharitis, or other ocular surface irritation * Regular use of artificial tears, ocular lubricants, or dry eye medications, or unwillingness to stop them during the study * Active or recent (within 30 days) ocular infection, or active dacryocystitis * Current use of ophthalmic anticholinergic agents (unless stopped at least 10 days before Visit 1) * Hypersensitivity to atropine, other anticholinergics, or any component of the formulation * Angle-closure glaucoma or narrow anterior chamber angles * Pregnancy or breastfeeding * Participation in another interventional study within 30 days * Any condition or medication that, in the investigator's judgment, would interfere with study assessments or subject safety