Blocked Tear Ducts: A Comprehensive Guide for Patients

Tears are essential for maintaining the health and comfort of our eyes. They lubricate the surface of the eye, help the corneas absorb oxygen, and contain immune factors that protect against and help the eyes recover from infections.

However, when something prevents tear fluid from draining properly, it can lead to disruptive symptoms like watery eyes or trouble seeing, and increase the risk of infection. This condition, known as nasolacrimal duct obstruction or blocked tear ducts, can affect both children and adults.

In this guide, we will explore the causes, symptoms, risk factors, complications, prevention, and treatments for blocked tear ducts.

Causes of Blocked Tear Ducts

Blocked tear ducts can be congenital, meaning they are present at birth, or can develop later in life due to injury, infection, or age-related changes.

Congenital Blocked Tear Ducts

In newborns, blocked tear ducts are common. The condition usually happens because a child still has an unbroken membrane where the valve of Hasner should be, which means fluid can build up inside the lacrimal duct. Over time, the accumulated tear fluid can cause the duct to expand and lead to an infection of the tear duct or other parts of the tear system.

Blocked Tear Ducts in Adults

In adults, blocked tear ducts can develop due to various reasons, including:

• Injury or trauma to the face or eye
• Inflammation or infection of the eyelid or eye
• Growths or tumors in the nasolacrimal duct or surrounding area
• Age-related changes, such as narrowing or hardening of the duct

Symptoms of Blocked Tear Ducts

The symptoms of a blocked tear duct can include:

• Excessive tearing or watery eyes
• Eye irritation, redness, or discomfort
• Crusting or discharge around the eye, especially upon waking up
• Blurred vision or difficulty seeing
• Recurrent eye infections or inflammation

Risk Factors and Complications of Blocked Tear Ducts

While anyone can develop a blocked tear duct, certain factors can increase the risk, such as:

• Age: Blocked tear ducts are more common in older adults due to age-related changes.
• Prolonged eye inflammation: Persistent eye irritation, redness, and inflammation can elevate the likelihood of a blocked tear duct.
• History of surgical procedures: Prior surgeries involving the eyes, eyelids, nose, or sinuses may have led to scarring in the duct system, potentially resulting in a future blocked tear duct.
• Glaucoma: The use of topical anti-glaucoma medications directly on the eye can increase the risk of developing a blocked tear duct.

Prevention of Blocked Tear Ducts

Since blocked tear ducts can be caused by unpredictable or uncontrollable factors, there is no surefire way to prevent them. However, some steps can help reduce the risk, such as:

• Practicing good hygiene, including washing your hands and face regularly
• Avoiding contact with people who have eye infections or inflammation
• Following the manufacturer’s instructions for contact lens care and makeup removal
• Seeking prompt medical attention for eye injuries or infections

Treatment of Blocked Tear Ducts

The treatment of blocked tear ducts depends on the cause, severity, and location of the blockage. In some cases, the blockage may resolve on its own or with specialized massage technique that caregivers can administer at home. If your child or a child under your care is affected, their pediatrician can provide precise instructions on performing this technique. Typically, this massage is sufficient to encourage the membrane to open up, thereby establishing proper drainage.

However, if the blockage persists or causes significant symptoms, medical or surgical intervention may be necessary.

Medical Treatment

Medical treatment for blocked tear ducts can include:

• Antibiotics or antiviral eye drops to treat underlying infections
• Dilation, probing, and irrigation: A procedure that enlarges the punctal openings and guides a narrow probe through the tear drainage system to clear out any residual blockage.
• Balloon catheter dilation: A procedure that opens tear drainage passages that are narrowed or blocked by scarring or inflammation using a narrow catheter with a deflated balloon on the tip.
• Stenting or intubation: A procedure that uses tiny tubes to open up blockages and narrowing within the tear drainage system.
• Dacryocystorhinostomy (DCR): A surgical procedure that creates a new route for tears to drain out through the nose normally again by developing a new connection that bypasses the duct that empties into the nose (nasolacrimal duct), which is typically the blockage site.
• Conjunctivodacryocystorhinostomy (CDCR): A surgical procedure that reconstructs the entire tear drainage system, bypassing the tear drainage system altogether.

Final Thoughts

Blocked tear ducts can cause significant discomfort and affect one’s quality of life. However, with the expertise of ophthalmologist specialists and the availability of medical and surgical treatments, relief is within reach. By restoring proper tear drainage, these procedures can significantly reduce discomfort, excessive tearing, and the risk of recurrent eye infections, allowing individuals to resume their daily activities without hindrance.

If you or someone you know is experiencing symptoms of a blocked tear duct, we encourage you to seek the expertise of an ophthalmologist for proper evaluation and treatment. Don’t let a blocked tear duct interfere with your vision and well-being – take action today by consulting with an eye doctor.