What is a blocked tear duct?

The term blocked tear ducts refers to an issue where small tubes known as tear ducts never develop properly or never completely open. In a healthy eye, tear ducts help tears and other fluids drain from the eye. A blocked tear duct, however, prevents the flow and drainage of those fluids. As a result, the duct and tear sac in the eye may become swollen, inflamed, or infected due to the fluid backing up within them.

Unfortunately, while a blocked duct can strike at any age, they are most common in infants. In fact they affect about 6 out of 100 newborns. And unlike many eye health issues, which are preventable, blocked tear ducts at this age tend to be related to growth and development issues. Some experts think family history may also contribute to the risk of a child suffering from this condition. In most cases, blocked tear ducts often clear up on its own during the baby’s first year and they do not usually have any effect on the baby's vision or cause any vision problems.

What causes a blocked tear duct?

The most common cause of a blocked tear duct is the failure of the tissue at the end of the tear duct to open normally. Other than that, there are a few other causes of blocked tear ducts in babies. They are:

• Abnormal growth of the nasal bone that puts pressure on a tear duct and closes it off.
• Eye or any other type of infection during gestation
• Undeveloped openings in the corners of the eyes, leading to the inability to drain tears into the tear ducts.
• Hereditary and genetic factors, with a family history of blocked tear ducts

In the case of adults, a blocked tear duct may sometimes be caused due to aging or an bone or tissue injury around the eyes. Several other disorders like the thickening of the tear duct lining, or aberrant tissue growth in the nose, or problematic outcomes from a nasal surgery could cause the blockage of the tear ducts in adults.

What are the symptoms of a blocked tear duct?

In many cases, only one eye at a time is affected by this condition. Symptoms that parents and doctors may notice in children as this issue develops include:

• Excessive tearing: If a duct is blocked, a child’s eye may look particularly watery due to fluid build-up. Some children may continuously have tears running down their face as well.
• Build-up: Children dealing with a blocked duct may develop yellow or white build-up in the corner of their eye.
• Stuck eyelids: Children may have trouble opening their eyes, due to the pressure and build-up of fluids or other substances related to the condition.
• Swelling or redness around the eye or the nose: Due to pressure or infection, a blocked tear duct may create redness or swelling around a child’s eyes or nose. In cases of infection, children may also experience fever, pain, increased mucus drainage from the nose, or pus drainage from the eye.

It is especially noteworthy that these symptoms are likely to present within days or weeks after a child is born. If a tear duct is blocked, parents and doctors will know about it sooner rather than later. The symptoms of a blocked tear duct may be exacerbated following an upper respiratory infection like a cold or sinus infection. Chill wind, cold weather, and sunlight also may make symptoms worse.

How is a blocked tear duct diagnosed?

Diagnosing a blocked tear duct is usually done by a thorough understanding of the patient’s medical history, followed by an eye exam. Our eye doctors may also employ tests to measure the amount of tears and check if the tears are draining normally from the eyes. A few other tests could also be used to help the doctor find out where the blockage is or how it was caused.

How are blocked tear ducts treated?

The good news is that a blocked tear duct in a child will often resolve itself within the child’s first year. During this time, parents will be able to assist in treating the issue at home, primarily by helping to keep the affected area clean. To help prevent infection and other problems until the blockage goes away, parents are always advised to:

• Keep the eye of the child clean. This should be done by wiping away the drainage by moistening a clean cotton ball with warm water, and wiping gently from the inner part of the eye (near the nose) to the outer part of the eye. If your pediatric ophthalmologist suggests it, you can also gently massage the area of the blockage to prevent fluid buildup in the duct.
• Reduce your child’s exposure to wind, cold, and sunlight.
• Keep your hands clean by washing it with a non-irritant soap before and after you touch the eye area to prevent infections. If any infections arise, your child might have to be administered with antibiotics. 

In some cases, young children may need to undergo surgery to address the problem. For example, what is known as a probing procedure may be carried out to open the duct, if it does not clear on its own. Probing successfully opens a blocked duct in about 80 out of 100 cases of the condition.

In some cases, if necessary, doctors may look into stenting or intubation to help address a blocked duct. During this process, tiny tubes are threaded through a child's drainage system, to help fluid drain and unblock the system. Stenting can help keep a child comfortable by reducing the tearing and discharge. If, however, a blocked duct does not resolve naturally or with stenting, your doctor will recommend more complex surgery to address the issue. The procedure, known as a dacryocystorhinostomy, is rarely performed in children, but is sometimes necessary to assist in resolving this condition. During this surgery, surgeons create a new route for tears to drain through a child's nose, bypassing the blocked duct. Stents or intubation are also often included in this procedure, and used temporarily to assist in the draining of fluid.

At Everett & Hurite, we believe in using the latest techniques of tear duct surgery using an endoscope. Ultimately, though, the exact steps needed during a child’s care and surgery will be decided on a case by case basis. Call today or use the online scheduling tool to learn more about this condition from our providers.