Blocked Tear Duct

Diagnosis of Blocked Tear Duct

Diagnosing a blocked tear duct involves evaluating your symptoms, examining your eyes, and performing specialized tests.

• Symptom Review and Eye Examination:

  • Your healthcare professional will ask about tearing, discharge, or recurrent eye infections.

  • The inside of your nose may be checked for structural changes contributing to blockage.

• Tear Drainage Test:

  • A drop of special dye is placed on each eye to measure tear drainage.

  • If dye remains after five minutes, a blockage may be present.

• Irrigation and Probing:

  • Saline may be flushed through the tear system, or a slender probe may be inserted through the puncta (tiny eyelid drainage openings) to locate or treat blockages.

• Eye Imaging Tests:

  • Contrast dye is passed through the tear duct system.

  • X-ray, CT scan, or MRI can help pinpoint the location and cause of the blockage.

Treatment of Blocked Tear Duct

Treatment depends on the cause and severity of the blockage, and multiple approaches may be combined.

• Medicines to Treat Infection:

  • Antibiotic eye drops or oral medications are prescribed if an infection is present.

• Watch-and-Wait or Massage:

  • Many infants’ tear ducts improve naturally within the first months of life.

  • Gentle massage techniques may help open a thin tissue membrane covering the nasolacrimal duct.

  • Adults with facial injuries may wait for swelling to subside before treatment.

• Dilation, Probing, and Flushing:

  • Infants: Done under general anesthesia; punctal openings are dilated and a thin probe is used.

  • Adults: Partial punctal narrowing may be treated with simple irrigation, often providing temporary relief.

• Stenting (Intubation):

  • A thin tube is threaded through the puncta into the nose to keep the tear duct open.

  • Tubes are typically left in place for about three months.

  • Possible complications include inflammation.

• Balloon Catheter Dilation:

  • Used if other treatments fail or blockage recurs.

  • A catheter with a balloon is threaded through the tear duct and inflated to open the passageway.

• Tumor-Related Blockages:

  • If a tumor is causing the blockage, treatment targets the tumor, possibly including surgery or other therapies.

Surgery for Blocked Tear Duct

The most common surgical procedure is dacryocystorhinostomy (DAK-ree-oh-sis-toe-rye-nohs-tuh-me), which opens the tear drainage passage.

• External Dacryocystorhinostomy:

  • A cut is made near the lacrimal sac to connect it to the nasal cavity.

  • A stent keeps the passageway open, and the incision is closed with stitches.

• Endoscopic or Endonasal Dacryocystorhinostomy:

  • Instruments and a camera are inserted through the nasal opening.

  • No external incision or scar, but success rates may be slightly lower than the external approach.

• Post-Surgery Care:

  • Nasal decongestant sprays and eye drops prevent infection and reduce inflammation.

  • Stents are usually removed after 6 to 12 weeks of healing.