Tear Duct Obstruction: Causes, Symptoms, and Treatment Methods
The tear system keeps the eyes moist and acts as a defense mechanism against infections. However, blockage of the tear duct can lead to significant eye health issues.
What Is Tear Duct Obstruction?
Tears produced by the lacrimal gland moisten the eye surface and then drain through the tear duct into the nasal cavity. When this duct becomes blocked for any reason, tears cannot flow properly into the nose and instead accumulate in the eye. As a result, tears may overflow onto the cheeks, and symptoms such as watery eyes, discharge, and infection may appear.
What Are the Symptoms?
Common symptoms of tear duct obstruction include:
- Constant tearing (watery eyes)
- Frequent eye discharge and infections
- Redness and swelling in the eye
- Discharge from the nose bridge when pressed
- Tenderness and swelling at the inner corner of the eye
These symptoms are especially common in newborns and postmenopausal women.
Causes of Tear Duct Obstruction
Tear duct obstruction can occur at any age and is classified into congenital (present at birth) and acquired (developed later in life) causes:
- Congenital Tear Duct Obstruction: Common in newborns and usually results from tear ducts not fully opening at birth.
- Acquired Tear Duct Obstruction: Can develop due to aging, chronic infections, eye trauma, tumors, or surgeries around the eyes.
Diagnosis and Diagnostic Methods
The most commonly used method to diagnose tear duct obstruction is the lacrimal irrigation (lavage) test. During this test, fluid is passed through the tear ducts, and the doctor checks whether it reaches the throat. If the fluid does not pass through, the duct is considered blocked.
Additional imaging techniques such as dacryocystography and dacryoscintigraphy may also be used for more detailed evaluation.
Treatment Options
Treatment for Congenital Tear Duct Obstruction
In newborns, blockages usually resolve on their own with massage and medication. Massage applied from the corner of the nose downward can help open the duct. This method has a success rate of about 95% if applied within the first year. If the obstruction persists, the following treatments may be considered:
- Probing: A thin probe is inserted into the tear duct to open the blockage.
- Balloon Catheter Dilation and Tube Intubation: If probing is unsuccessful, the duct can be widened or supported with a silicone tube.
- Dacryocystorhinostomy (DCR) Surgery: If other treatments fail, surgery may be required.
Treatment for Acquired Tear Duct Obstruction
In adults, tear duct obstructions are usually treated surgically. One of the most common procedures is Dacryocystorhinostomy (DCR), which creates a new drainage pathway between the tear sac and the nasal cavity.
In some cases, a temporary silicone tube may be inserted to keep the new channel open and prevent re-blockage.
Conclusion
Tear duct obstruction is a manageable condition when diagnosed and treated in a timely manner. In infants, early massage and eye drops often lead to resolution without surgery. In adults, surgical treatment typically yields successful outcomes.
If you experience persistent tearing, discharge, or swelling near the inner corner of the eye, it’s important to consult an eye specialist. If surgical treatment is required, ENT and ophthalmology specialists will work together to manage your care.
