In a patient with an open-eyed coma, tears in the eyes when hearing a family member speak may be tears due to conditioning of the eyes and are not a reaction to a change in the patient’s mood. A patient in an open-eyed coma is actually unconscious, although his or her eyes are open. This type of patient generally has suffered severe brain damage, resulting in a loss of his or her higher intellectual activity, and will not respond to changes in the external environment, such as the words of family members. Nor will they have emotional responses such as sadness, joy, or irritability. However, patients who are in a coma with their eyes open may occasionally have tears in their eyes, which is a conditioned reflex caused by stimulation of the tear ducts and other tissues of the eye by touch. If the patient wakes up from a coma and resumes emotional responses, the tearing is often accompanied by other symptoms such as talking with eyes closed and voluntary movements of the arms and legs. It is advisable to have a doctor review the patient’s condition to determine the exact cause of the tearing.