Blocked Tear Duct

Condition

A blocked tear duct is when the eye's drainage system for tears is either partially or completely obstructed. Tears cannot drain normally, causing a watery, irritated or chronically infected eye.

Most of your tears come from your lacrimal glands, which are located above each eye. The tears flow down the surface of your eye to lubricate and protect it, and then drain into tiny holes (puncta) in the corners of your upper and lower eyelids. The tears then travel through the small canals in the lids (canaliculi) to a sac where the lids are attached to the side of the nose (lacrimal sac), then down a duct (the nasolacrimal duct) before emptying into your nose, where they evaporate or are reabsorbed. In adults, the tear duct obstruction can result from an eye infection, swelling, injury or a tumor.

A baby can be born with a congenital blocked tear duct. It is estimated nearly 20 percent of newborns have a blocked tear duct, but the condition usually resolves on its own within the first year of life. However, if the tear duct needs clearing surgically, nasolacrimal duct surgery may be indicated.

Symptoms

When tear ducts are blocked, trapped bacteria in the nasolacrimal sac can lead to infection (called dacryocystitis). Symptoms of infection include:

  • Inflammation (swelling), tenderness and redness of the inside corner of the eye or around the eye and nose
  • Recurrent eye infections
  • Eye mucus discharge
  • Crusty eyelashes
  • Blurred vision
  • Blood-tinged tears
  • Fever

Treatment

In most cases of blocked tear ducts after a facial injury, the drainage system starts working again on its own a few months after the injury, and no additional treatment is necessary.

If a blocked tear duct isn't opening on its own, a technique using dilation, probing and irrigation may be used. An instrument is used to enlarge (dilate) the punctal openings and a narrow probe is guided through the puncta, into the tear drainage system, then through the nasal opening and removed. The tear drainage system is flushed with a saline solution to clear out any residual blockage.