Blocked Tear Duct
A blocked tear duct is when the eye’s tear drainage system is either partially or completely blocked. Tears cannot drain properly, resulting in a watery, irritated or chronically infected eye.
FAQs
Blocked tear ducts can happen to anyone of any age. Causes of blocked tear ducts include:
- Age: As you get older, your puncta may naturally narrow.
- Congenital blockages: Some babies are born with tear ducts that are narrow or not fully formed (dacryostenosis).
- Infection: Chronic sinus infections or eye infections can lead to blockage.
- Injury: Any eye injury near the tear ducts, even a scrape from tiny dirt particles, can cause a blockage.
Tumors: A tumor anywhere near the tear ducts, such as in the nose, can cause blocked tear ducts.
Babies don’t start producing tears until they are a few weeks old. You may not notice a blocked tear duct in a newborn right away. As babies get older, blocked tear duct symptoms might include:
- Redness around the eye, usually from your baby rubbing the eye.
- Tears that drain down the baby’s cheek instead of out of the eye corner.
- Tears pooling near the corner of the eye but not draining.
- Yellowish discharge or mucus in the baby’s eye.
Tests used to diagnose a blocked tear duct include:
- Tear drainage test. This test measures how quickly your tears are draining. One drop of a special dye is placed on the surface of each eye. You may have a blocked tear duct if after five minutes most of the dye is still on the surface of your eye.
- Irrigation and probing. Your doctor may flush a saline solution through your tear drainage system to check how well it’s draining. Or he or she may insert a slender instrument (probe) through the tiny drainage holes at the corner of your lid (puncta) to check for blockages. In some cases this probing may even fix the problem.
Eye imaging tests. For these procedures, a contrast dye is passed from the puncta in the corner of your lid through your tear drainage system. Then X-ray, computerized tomography (CT) or magnetic resonance imaging (MRI) is used to find the location and cause of the blockage.
Often, a blocked tear duct in a newborn resolves without treatment. In the first few months of life, the baby’s tear ducts may mature and eliminate the blockage.
Sometimes, a baby still has a small piece of tissue blocking the flow of tears inside the nose. Your baby’s provider may teach you a special eyelid massage technique. This massage helps open the tissue so tears can drain as they should.
If a watch-and-wait approach does not work, providers may use dilation and flushing, balloon catheters or stents. These treatments work the same way in babies as they do in adults. However, providers use general anesthesia to keep babies still and calm during the procedure.
Blocked tear duct treatment depends on the cause. For example, if you have a tumor, your treatment focuses on removing or shrinking the tumor.
Additional treatment options may include:
- Medications: If an eye infection caused the blockage, your provider may prescribe oral antibiotics or medicated eye drops.
- Dilation, probing and flushing: Your provider enlarges the opening at the corner of your eye. Then, using a small probe, your provider sends fluid through the tear duct. Usually, this “flushing” removes the blockage at least temporarily.
- Stenting: Your provider places a small, hollow tube (stent) through the puncta and into the tear duct. The tube allows tears to drain properly. The tubes stay in place for about three months. You will see a small portion of the tube out of the corner of your eye.
- Balloon catheter dilation: Your provider places a small, deflated balloon into the tear duct. Then your provider inflates the balloon a few times to clear the blockage. You are usually under general anesthesia (medication to help you remain asleep) for this procedure.
Snip punctoplasty: Your provider makes two or three small incisions around your puncta. These incisions create a larger tear duct opening. Snip punctoplasty is a common treatment for partial blockages.
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