Tears are essential for maintaining eye health, lubricating the surface, and protecting against irritants and infections. They are produced by lacrimal glands and drain through a duct system. The nasolacrimal duct, commonly known as the tear duct, carries tears from the eye into the nasal cavity. When this pathway becomes blocked, tears cannot exit the eye properly, leading to symptoms. A blocked tear duct can affect individuals across all age groups, from newborns to older adults.
Recognizing the Signs
A blocked tear duct often causes several symptoms. The most common sign is excessive tearing, where tears continuously well up in the eye or run down the cheek, even when not crying. This constant wetness can lead to irritation and redness of the eye or surrounding skin. A common symptom is a gooey or crusty buildup on the eyelashes or eyelids, especially upon waking. This discharge can be white, yellow, or even greenish, indicating bacterial presence.
Individuals might also experience recurring eye infections, such as conjunctivitis, because undrained tears foster bacterial growth. Swelling near the inner corner of the eye can also occur, sometimes accompanied by tenderness or pain. Blurred vision is another symptom, as excess tears on the eye’s surface can interfere with clear sight.
In infants, a blocked tear duct is evident through constant watery eyes from birth or early weeks, even without crying. Parents might observe a sticky, yellowish discharge or pus, causing eyelids to stick together. While the eye itself may not be red, the surrounding skin can become irritated from constant moisture. If an infection develops, signs can include pronounced yellow or green mucus, eye redness, and a swollen eyelid.
Understanding Contributing Factors
Blocked tear ducts can develop for various reasons, affecting both infants and adults. In many newborns, the blockage is congenital, present from birth. This typically occurs because a thin membrane, the valve of Hasner, fails to open. This undeveloped or narrow duct prevents tears from draining into the nose.
As individuals age, the tiny openings that drain tears, called puncta, can narrow, leading to blockages. Trauma or injury to the face, around the eye or nose, can also contribute to a blocked tear duct. Swelling or scar tissue from such injuries can compress or obstruct the tear drainage pathways. Chronic infections or inflammation of the eyes, tear drainage system, or sinuses can also form scar tissue, leading to blockage.
A tumor in the nose or tear drainage system can exert pressure and impede tear flow. Certain medications, such as some glaucoma eye drops, have also been associated with blocked tear ducts. Chronic sinusitis and nasal polyps can cause inflammation and damage to nasal tissues, potentially contributing to blockages.
Medical Confirmation and Next Steps
Confirming a blocked tear duct typically involves a healthcare professional’s assessment of symptoms and a physical examination. The doctor will visually inspect the eye and the tear duct area. A common diagnostic procedure is the dye disappearance test, where a special dye is placed in the eye. If the dye remains on the eye’s surface for an extended period, it suggests a drainage issue. In some cases, the doctor might flush a saline solution through the tear drainage system or gently insert a slender instrument, called a probe, into the puncta to check for obstructions.
It is important to seek medical attention if symptoms persist, worsen, or if there are signs of infection, such as increased pain, significant redness, or fever. Persistent watery eyes that interfere with daily activities or frequent eye infections also warrant professional evaluation. While some blocked tear ducts resolve on their own, particularly in infants, a medical opinion can help prevent complications.
Treatment approaches vary based on the cause and age of the individual. For infants, gentle massage techniques applied to the tear duct area are often recommended to help open the blockage. Warm compresses can also provide relief and aid in managing discharge. If an infection is present, antibiotics, often in the form of eye drops, may be prescribed.
For cases that do not resolve with conservative measures, or for adults, other interventions might be considered. These can include probing, where a thin rod is used to open the duct, or the temporary placement of stents to keep the duct open. In more severe or recurrent cases, surgical options, such as dacryocystorhinostomy (DCR), may be necessary to create a new drainage pathway for tears.