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Blocked Tear Ducts

What are tears?

Tears are a clear fluid that is continuously made by the tear glands to keep the surface of the eye moist and to clean the eyes. The tears drain into the nose through a small opening (punctum) in each eyelid near the corner of the eye. They then drain down the tube called the tear duct (the nasolacrimal duct) into the nose.

What is a blocked tear duct?

A blocked tear duct means something is stopping the flow of tears away from the eye down the tear duct into the nose. One or both eyes maybe affected.

What causes a blocked tear duct?

Blocked tear ducts are usually present at birth (congenital). Occasionally they appear later in life (acquired). A congenital blocked tear duct is usually caused when the nasolacrimal duct fails to open at its lower end in the nose.

What happens when your child has blocked tear ducts?

• Your child may have wet eyelashes or a lot of tears. Since the tears cannot drain out of the tear duct, they spill over the lashes often onto the cheek.
• Your child’s eyes may often be stuck together with mucus, especially in the morning. This mucus is not pus (a yellowish or greenish discharge) caused by infection. Mucus is something normally dissolved in the tears that is left on the rim of the eye when tears do not flow well.
• Your child may repeatedly have a red eyeball because of infection since the tears cannot cleanse the eyes.

Does tearing always mean my child has blocked tear ducts?

Tearing is not always due to blocked tear ducts. Since it could be due to a number of things, you should have your child’s eyes checked by an eye doctor.

What is the treatment for blocked tear ducts?

Treatment may include one or more of the following. Your doctor will explain what type of treatment is best for your child.

Medical

• Rubbing (massaging) the lacrimal (tear) sac, usually 4 to 6 times a day, will help open the duct (see diagram).
• Antibiotic drops or ointment is sometimes given if there is an infection (see pamphlets How to Apply Eye Drops and How to Apply Eye Ointment).

Surgical

Surgery may be necessary if medical treatment has not worked after several months or if the skin between the eyeball and the side of the nose is red and swollen. Surgery is done as day surgery under a general anaesthetic.

There are different types of surgical procedures:

• Probing and irrigating (the most common method). A thin blunt probe is inserted into the tear duct to unblock the obstruction. An irrigating tube might then be inserted if necessary and saline solution is flushed through it. The tube is then removed.
• Inserting a silicone tube into the tear duct for a number of weeks to prevent re-obstruction of the tear duct.
• Creating a new opening through the bone into the nose (Dacrocystorhinostomy).

What will happen after surgery?

• Your child may continue to have tearing and discharge for a few day.
• Your child’s tears and nasal discharge may be slightly stained with blood for a day or two.
• Your child may be given eye drops for the affected eye.
• Your child may need a follow-up appointment (check with your doctor).
• If your child has had tubes placed into the tear duct, they are usually removed a few weeks or months after the surgery. These are usually removed without general anaesthetic.
• Occasionally, if your child’s symptoms return, surgery may be necessary again.