A blocked tear duct is an obstruction or complete scarring of the nasolacrimal duct in the nose. This duct is more commonly known as the tear duct.
Tears have three components: liquid, mucous and oil. The tears are produced by the lacrimal (tear) gland, the oil glands in the lid and mucous glands in the white part of the eye (the sclera). The tears are constantly released onto the eye's surface in small amounts. Blinking moves tears toward the inside corner of the eye. There the tears drain through small canals into the nasolacrimal sac in the nose.
From there, the tears go down the tear duct into the back of the nose and then down the throat. If there is a barrier anywhere along this route, it is called a blocked tear duct. This can happen on one or both sides of the nose.
The major symptom of a blocked tear duct is constant tearing and watering of the eye. Tears run down the face. Sometimes, there is mucus on the lid margins and lashes. Occasionally, there is a secondary infection in the nasolacrimal sac. This causes tenderness on the side of the nose near the affected eye.
Eight per cent of newborn babies often have discharge and tearing of the eyes. This is because a membrane in the nose is blocked. Usually, it opens spontaneously at birth. Even if the membrane does not break during birth, the problem usually goes away after a few months.
However, if the membrane does not open by itself in 6 to 9 months, the chance that it will self-correct is low. Treatment will be required. Sometimes, a past nose injury or frequent sinus infections can cause scarring of the nasolacrimal duct. This can cause complete blockage of the duct.
Diagnosis of a blocked tear duct begins with a history and physical exam. When there is constant tearing and discharge in one or both eyes, a blockage is suspected. In an adult, frequent watering or infections can be signs of a blocked tear duct.
A healthcare professional can confirm the diagnosis by trying to rinse the nasolacrimal system. A small tube is placed into the opening on the lower lid. Then fluid is channeled into the nose. If it does not flow into the back of the nose, and the person cannot taste it going down the throat, a blocked tear duct is diagnosed.
Tears and mucus can build up in the nasolacrimal sac, creating an environment for infection. The constant watering and discharge of the eye can cause secondary infections of the eyelids and conjunctiva.
A blocked tear duct is not contagious and poses no risk to others.
In babies, treatment consists of good eyelid hygiene and massage downward over the nasolacrimal sac with a cotton-tip applicator. Sometimes, this procedure will open the membrane at the end of the duct. If the tear duct has not opened spontaneously by 6 to 9 months of age, probing to open the blocked duct under anesthesia is recommended. Probing will pop the membrane open in the nose.
A blocked tear duct in adults may respond to massage. A healthcare professional can demonstrate how to massage the area around the lacrimal sac. Often, however, surgery is recommended. The opening to the tear duct will narrow with age and can be opened in the office with dilation. If the tearing persists, small tubes can be placed in the duct for several months to promote drainage.
If these approaches fail, a more extensive operation may be required. The procedure is called a dacryocystorhinostomy (abbreviated as DCR). It creates a new opening in the nose so tears can flow into the back of the throat.
Surgery can be complicated by bleeding, infection, or allergic reactions to anesthesia.
Following successful treatment of the blocked tear duct, the individual should have no more watering or discharge of the eye.
Any new or worsening symptoms should be reported to the healthcare professional.