Tear ducts are structures that drain tears from your eye and into your nose. They’re also known as nasolacrimal ducts.
If these ducts become clogged, it’s called a blocked tear duct or nasolacrimal duct obstruction. It can cause symptoms like eye irritation and discharge.
This condition can occur in both infants and adults, but for different reasons. In this article, we’ll explain the causes, symptoms, and treatments of a nasolacrimal duct obstruction.
The openings of each tear duct are in the corners of your upper and lower eyelids. They empty into the nasal cavity. They look like small dots, one on each eyelid.
Tear ducts help tears drain from the eye. They bring the tears through the nasal bone and into the back of the nose.
If your tear ducts become blocked, known as nasolacrimal duct obstruction, tears cannot drain through your nose. This can cause a backflow of tears, resulting in various symptoms.
The following symptoms may indicate a nasolacrimal duct obstruction in infants or adults.
If you have any of these symptoms, consult with your doctor:
- excessive tearing
- overflow of tears on the eyelashes, eyelids, and cheeks
- inflamed, swollen eyelids
- eyelids getting stuck together
- yellowish-green mucus discharge
- chapped skin around the eyes
- recurrent eye infections
Symptoms might appear worse after:
- a cold or sinus infection
- exposure to sunlight
- exposure to cold or wind
The causes of nasolacrimal duct obstruction in infants and adults are slightly different.
In infants, a nasolacrimal duct obstruction can develop when the tear duct fails to open fully at birth. This is the most common cause. There are no genetic or gender risk factors associated with this cause.
Other possible reasons for blocked tear ducts in infants include:
- narrow tear ducts
- having no puncta (the small opening in the eyelid)
- tumors or masses
- nasolacrimal duct cysts
Skull or facial structural differences, like those seen in Down syndrome, increase the risk of a nasolacrimal duct obstruction.
More than 5% of infants have symptoms of a tear duct obstruction in one or both eyes, according to the American Academy of Ophthalmology (AAO). About 90% of these cases get better on their own, the AAO says.
In adults, a nasolacrimal duct obstruction can develop due to:
- chronic nasal infections
- nose injury, like a broken nose
- nasal polyps
Your doctor may use the following tests to diagnose a blocked tear duct:
- Physical exam: In most cases, diagnosis can be made on symptoms alone. Your doctor will examine your eye and any discharge coming from it.
- Medical history: Knowing your medical history can help your doctor determine if you’re at risk for blocked tear ducts. For example, being prone to chronic nose infections can increase your risk.
- Dye disappearance test: This test uses dyed eye drops to determine if your tear ducts are blocked. If the eye drops disappear within 5 minutes, there’s no tear duct obstruction.
In infants, a tear duct obstruction usually goes away within a few months after birth. Similarly, an obstruction caused by a facial injury can clear up on its own.
If the blockage persists, your doctor may recommend the following treatments. These therapies can also work for adults.
Tear duct massage
A tear duct massage can help open up the tear duct. You can do this at home.
For infants, a caregiver can perform the massage using their index finger. It involves placing firm pressure in a downward movement on the tear duct.
Adults can perform a tear duct massage on themselves. Your doctor can explain the best way to do the massage. They may suggest doing it two or three times per day.
Antibiotic eye drops
If there’s severe discharge around the eye, antibiotic eye drops may be necessary.
The eye drops won’t open up the tear ducts. However, they can help control symptoms and treat eye infections.
If a blocked tear duct fails to open on its own or ends in a cyst, several procedures can help. These can be done for both infants and adults.
These procedures include:
- Probing: In this procedure, a healthcare professional will use a probe to widen the tear duct openings. A saline solution is also flushed through the tear ducts to remove any blockage.
- Balloon catheter dilation: A healthcare professional may recommend this procedure if the tear ducts are blocked by scarring or inflammation. It involves inserting a narrow tube with a deflated balloon into the tear duct, then inflating the balloon.
- Stenting: Stenting involves the insertion of thin tubes into your tear ducts. The tubes remain for 3 or 4 months before being removed.
- Dacryocystorhinostomy: This surgery is usually done in adults. It creates a new route for tear ducts to flow into your nose.
If a nasolacrimal duct obstruction is left untreated, bacteria can multiply in the area. This can lead to an infection known as dacryocystitis.
In infants, it’s not possible to completely prevent a blocked tear duct. That’s because they’re usually born with the condition.
Tear duct obstructions in infants usually go away on their own. But it’s still important to bring your baby to the doctor if they have a blocked tear duct. This can help prevent further complications.
In adults, you can prevent a nasolacrimal duct obstruction duct by reducing the risk factors. This includes:
- treating or managing chronic nose infections
- protecting your face to prevent injury
- seeing your eye doctor for regular checkups
- consulting with your doctor when you have an eye inflammation or infections
A nasolacrimal duct obstruction is a blocked tear duct. In infants, it typically happens when the tear duct fails to develop fully. This usually goes away within a few months.
In adults, a nasolacrimal duct obstruction may be caused by chronic nose infections, nasal polyps, tumors, or a nose injury. Aging also increases the risk.
Depending on your symptoms, your doctor may recommend a tear duct massage or antibiotics. If the blockage persists, the tear duct can be widened with various procedures.