Tear Duct System
Tear ducts are membranous canals that drain tears from the eyes into the nasal cavity. Blocked tear ducts, also known as dacryostenosis or congenital lacrimal duct obstruction, is a common condition in infants that may affect one or both eyes. Blocked tear ducts may also occur in adults resulting in a persistently watery eye.
Tears are a saline liquid produced in the lacrimal gland, located under the browbone behind the upper eyelids. Tears keep the eyes lubricated and clear off dust, microorganisms and other particles. Tears also contain antibodies and protect the eyes from infections. Tears move along the eyelids and drain through small openings called lacrimal ducts, located at the inner eyelid. Tears drain into the lacrimal sac and then, through the nasolacrimal ducts, they drain into the back of the nose. Lacrimal ducts and nasolacrimal ducts are called tear ducts.
In cases of tear duct obstruction, the nasolacrimal ducts are blocked because of infection or from birth causing accumulation of fluid in the tear sac leading to possible inflammation or infection along with consistent tearing of the eye.
Blocked tear ducts is often diagnosed by symptoms such as pooling of tears in the corner of the eyes; excessive tearing that runs down the cheeks; flow of tears as if the child is crying though the child is actually not crying; mucus or yellowish discharge in the eyes; and reddened skin below the eyes.
Though blocked tear ducts is sometimes a congenital condition it may not be evident at birth because infants produce tears only after several weeks following birth. In most congenital cases, the blocked tear ducts open on their own by the age of twelve months.
The condition is diagnosed based on the medical history and physical examination. No additional tests are usually required to confirm the diagnosis.
You will be instructed to keep the eyes and eyelids clean. Wash the eyes with a warm wet wash cloth. Gentle massage of the tear ducts 2 to 3 times a day may be recommended. Only in cases of infection are antibiotic eye drops or ointment prescribed.
In cases where the ducts do not open by their own by one year of age, surgical probing may be performed. In this procedure, the doctor will insert a probe into the nasolacrimal duct to open it. Occasionally, a small tube or stent is placed into the nasolacrimal duct to keep it open. In adults who have a blocked tear duct, an endonasal DCR (dacryorhinostomy) procedure may be required.