Blocked Tear Duct Treatment for Adults and Babies
Blocked Tear Duct?
If you have watery eyes, a painful swollen area at the inside corner of your eye, or suffer from recurrent eye infections, you just might have a blocked tear duct. Adults, children, and newborn babies can suffer from this condition. Read on to find out more about the symptoms and causes, whether surgery is necessary, and other treatment options.
Tears, Tear Glands, and Tear Ducts
Tears are vital to the health and function of the eye. They are produced in glands inside the upper eyelids, as shown in the illustration above. These lubricating tears flow over the surface of the eye and unless we are producing excess (crying, for example), they will normally drain through very tiny holes called puncta, which are found in the inside corners of both the upper and lower eyelids.1
Tears normally drain down through small channels and into a small reservoir, or lacrimal sac, and are reabsorbed by the body from here.
A blocked tear duct is not necessarily at the opening of the duct; it can occur at any point between the punta and the lacrimal sac.
Massaging Baby's Blocked Tear ducts
If your baby has "mucky" eyes and the pediatrician has checked your baby over, the video below has helpful advice on how to gently help to open the tear ducts.
Good advice is to do this whilst your baby is sleeping!
Take a clean finger—your ring or pinkie finger would be best—and gently place it in the nook beside the eye at the side of the nose, where the tear duct is, and gently massage in a counterclockwise direction. Skip to about the 1.33 section of the video below for a demonstration of this.
Treatments for Blocked Tear Ducts in Babies
Cleaning a Baby's Sticky Eyes
In the meantime, whilst your baby has the blocked tear duct, the eyes will be gunky and sticky, particularly after sleeping. Go to the 3-minute mark on the video (above) for how to clean the baby's eyes with cotton balls and sterile water (you could use cooled, freshly boiled water for this).
- Using a clean clean cotton ball, dip into the cooled water and wiping gently from the inside corner out (never work back towards the nose).
- When you need to re-moisten the cotton ball, get a fresh one. NEVER dip this back into the water.
- Always use a fresh cotton ball for the other eye if this needs treating, too.
My top tip, learned from a friend in the US, who had a baby girl in 2016, is to buy a pack of for use when you are away from home. These were recommended by her pediatrician for when she was out and about and not able to use the method outlined above for her baby's sticky eyes. Dr. Fischer's baby eye wipes
Dr. Fischer's baby eye wipes come in individual, sealed sachets (30 in a pack) and will not irritate sensitive eyes. She found them very effective. Thankfully, her baby's eye problems have now resolved, but she says she still keeps a couple in her purse, just in case.
Did your baby have a blocked tear duct at birth? If so,
What if The Baby's Blocked Tear Duct Does Not Resolve?
In 90% of infants or more, the problem will resolve. If not though, surgery can solve the problem. Nasolacrimal Duct Probing 2 is a procedure that often resolves the problem. Sometimes a tiny tube or stent is inserted into the duct and left in place for around six months after which time it is removed, and the duct is then open. Check out the video for a full explanation.
Confirming The Diagnosis of a Tear Duct Blockage for An Adult
Many people suffer from a blocked lacrimal duct (this is the medical term for a tear duct). Sometimes these resolve themselves—for example if you have a heavy cold or a sinus infection, the linings of the drainage channels for your tears may become inflamed, leading to restriction of flow of your tears and causing your eyes to water uncomfortably. These problems will resolve when the inflammation goes.
However, there are times when you should definitely see your doctor. If your eye has been watery for no apparent reason, you keep getting eye infections, or you have an irritated or sore eye, you should get this checked out.
In very rare cases the cause could be a tumor. Whilst this might sound alarming, getting a swift diagnosis and early treatment will ensure the best possible outcome. 3
There are a couple of different tests that Doctors do that help them.
Fluorescein Dye Test
The first one you might come across is the Fluorescein dye test .4 This involves instilling a small amount of fluorescein solution into the space between your lower eyelid and eyeball (the conjunctival sac). Fluorescence from the tear film is measured and the rate of disappearance of this fluorescence gives a measure of the rate of drainage of tears.
The Drop Test
A newer test, the Drop Test, is more sensitive than the fluorescein one. It simply involves instilling a lukewarm solution of saline in the same way as the fluorescein dye above. It is left there for three minutes and then any remaining solution is removed and measured. The difference between the amount of saline solution instilled and the amount removed, gives a measurement of how much has been drained away by the tear duct.
Home Remedies For Blocked Tear Ducts
- Use a cotton washcloth wrung out after soaking in hot water as a compress over the eyes. Leave on for about five minutes at a time.
- Massage the internal corner of your eye as shown in the video treating babies with blocked tear ducts.
- Massage your eyelids clockwise and then counterclockwise for about half a minute.
- Pinch the bridge of your nose by placing the tip of your index finger on either side. Then run your fingers down the line of the bone on either side.
Whichever method you choose, repeat a few times each day.
Surgical Procedures for Blocked Tear Ducts
Two types of surgical procedure either from the outside or from the inside of the nose can be done to reroute the tear drain, making the drainage slightly higher up. This effectively turns the narrowed, partially blocked drainage tube into the equivalent of an "eight lane highway" so that effective tear drainage is restored.
Both types of surgeries are outpatient procedures although there can be some bruising and swelling after the procedure. Patients sometimes worry that the procedure has not worked as they still have tearing immediately after the surgery but this is due to the swelling and as this subsides, the tearing will diminish.
Once treated, the chances of the blockage coming back after treatment are small—fewer than 10% of patients have a recurrence.
Endoscopic Laser Assisted Dacryocystorhinostomy (ELA-DCR)
Endoscopic Laser-Assisted Dacryocystorhinostomy is a surgical procedure used for treating blocked tear ducts.5
The video below shows the procedure in some detail. It involves using an endoscopic laser inserted through the nose. If you are a bit squeamish, the video is quite graphic but does show how beautifully simple the operation is.
Patients can resume their normal lives and go back to work, etc., the very next day.
Nasolacrimal Duct Stone Removal
A "stone" forming in the Nasolacrimal duct, although rare, is another cause of a blockage in the drainage system. 6 The video on the right shows the procedure for removing one in a simple, endoscopic procedure performed through the nose.
Causes of Blocked Tear Ducts
Babies: 7 Many babies have blocked tear ducts when they are born, especially if they are born prematurely and the tear drainage system has not developed completely. Often this resolves very quickly; there might be a very thin membrane covering the drainage duct which usually sorts itself out by the time the baby is around eight weeks old. Sometimes these congenital tear duct blockages as they are also called, take longer to resolve but most go away by themselves by the time the child is a year old.
Treatment may be medically advised or elected by parents sooner than this.
In Adults: 8
Growing Older: Partial blockage of tear ducts often occurs as we get older, particularly in women. This is usually caused by a narrowing of the opening of the tiny puncta in the corners of the eye through which the tears drain.
This slows down the flow of tears down the normal drainage channel and may cause "teary eyes" where the excess overflows the lower lids. Partial blockage is the most common problem of aging, although a total blockage can also occur.
Trauma: Sports injuries or an accident to the nose or cheekbone can cause a blockage as can previous surgery for an eye problem. Ongoing or chronic infections affecting your eyes or nose can also be a cause.
Medications: Sometimes medications and treatments can cause blockages. This could be a medication you are taking for an eye condition, such as glaucoma, which involves the use of eye drops or ointment. If you are undergoing chemotherapy or radiotherapy for a cancer, blocked tear ducts could be a side effect of the treatment.
Tumors: There is another cause of tear duct blockages and although this is quite rare, it is a good reason for getting any problems checked out. Tumors can grow in the nose, sinus cavity, or in the lacrimal sac where tears collect to be reabsorbed. These can cause a blockage as they grow, and early treatment is the best action!
In researching this article I read extensively. I have updated my article (April 2017) to provide a numbered key to the articles that, in my opinion, provide the most helpful information on the topics covered.
Here are the articles referenced:
1. Blocked Tear Duct Symptoms and Causes. (February 11, 2016). Mayo Clinic. Accessed April 18, 2017.
2. Should My Baby Have a Probing Procedure? (November 20, 2015). University of Michigan. Accessed April 18, 2017.
3. Blocked Tear Duct in Adults. (September 27, 2015). Pain Information Center. Accessed April 18, 2017.
4. Dye Disappearance Test. (n.d.). WebMD. Accessed April 18, 2017.
5. Endoscopic Laser-Assisted Dacryocystorhinostomy. (June 13, 2015). Don Santiago MD. Accessed April 18, 2017.
6. Stones In The Lacrimal Gland. (August 12, 2008). Wiley Online Library. Accessed April 18, 2017.
7. Tear Duct Blockage in Babies. (April 16, 2014). Patient. Accessed April 18, 2017.
8. Blocked Tear Ducts: Causes in Adults. (n.d.). WebMD. Accessed April 18, 2017.
Author's note: Where the citation shows (n.d), this indicates that no publication date was shown on the article.
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© 2013 Alison Graham