A blocked tear duct, also known as nasolacrimal duct obstruction, is a common condition that affects the eye’s natural drainage system. It can cause discomfort for individuals of all ages.
Understanding Blocked Tear Ducts and Discomfort Levels
The eye continuously produces tears to maintain moisture and cleanliness. These tears are generated by the lacrimal glands, located above each eyeball, and spread across the eye’s surface with every blink. Tears then drain through small openings, called puncta, near the inner corner of the eye, flowing into narrow tubes known as tear ducts, and finally into the nose. When a tear duct becomes blocked, this drainage pathway is obstructed, causing tears to accumulate on the eye’s surface and potentially overflow.
Many people wonder if a blocked tear duct causes pain. Generally, a blocked tear duct results in discomfort rather than sharp pain. This discomfort often manifests as irritation, a sticky sensation, or mild soreness. However, if an infection develops within the blocked duct, pain can increase significantly.
Common symptoms associated with a blocked tear duct include excessive tearing (epiphora), where tears spill onto the cheek. Other signs may involve crusting around the eye, particularly after sleep, mild redness of the white part of the eye, and slight swelling. This condition is particularly prevalent in infants, with about 1 in 20 babies being born with a blocked tear duct.
Common Causes and When to Seek Medical Care
Blocked tear ducts can arise from various factors, with some causes being more common in infants and others in adults. In newborns, a frequent reason is a congenital blockage, where a thin membrane covering the end of the tear duct has not fully opened at birth. This undeveloped membrane prevents tears from draining properly into the nose.
In adults, blocked tear ducts can stem from infections, such as dacryocystitis (inflammation of the tear sac). Injuries to the face or eye can also lead to blockages due to scarring or tissue changes. Less common causes include inflammation, nasal polyps, or, in rare instances, tumors pressing on the drainage system.
Seek medical attention if certain symptoms appear or persist. Indicators for consulting a doctor include signs of infection, such as increased redness, significant swelling, pus or thick discharge, or a fever. Consultation is also advisable if symptoms do not improve with home care, if there are changes in vision, if the pain is more than mild discomfort, or if blockages occur repeatedly.
Effective Management and Treatment Options
Managing a blocked tear duct often begins with home care techniques, effective especially for infants. Gentle massage of the tear duct area, located at the inner corner of the eye near the nose, helps encourage the membrane to open and facilitate drainage. This massage should be performed with a clean finger, applying gentle pressure downwards towards the nose. Applying warm compresses to the affected eye for 5-10 minutes can also help loosen blockages and provide comfort. Maintaining good eye hygiene by gently wiping away discharge with a warm, moist cloth is beneficial.
If home care is insufficient or an infection is present, medical interventions may be necessary. Antibiotic eye drops or oral antibiotics can be prescribed to treat bacterial infections, though they do not clear the blockage itself. For persistent blockages, particularly in infants, a procedure called probing may be performed. This involves gently inserting a thin probe into the tear duct to open the obstruction, which is often successful.
In cases that do not respond to probing, or for more complex adult blockages, other procedures exist. Balloon dacryoplasty involves inserting a catheter with a deflated balloon into the duct to widen the passage. Another option is intubation, where small tubes are temporarily placed in the tear ducts to keep them open for several months. For severe or chronic adult cases, dacryocystorhinostomy (DCR) surgery can create a new drainage pathway between the tear sac and the nasal cavity, bypassing the blocked duct entirely. Most infant cases of blocked tear ducts resolve on their own or with simple interventions, often by their first birthday.