Tears are produced by the lacrimal glands, located above the outer corner of each eye. These tears then spread across the eye’s surface with each blink, providing lubrication and washing away debris. Excess fluid normally drains through a system of tiny openings, called puncta, located in the inner corner of the eyelids, which lead into small tubes and eventually into the nasolacrimal duct, emptying into the nasal cavity. When this drainage pathway becomes obstructed, tears cannot drain properly, leading to a blocked tear duct.
Recognizing the Signs
A primary indication of a blocked tear duct in adults is excessive tearing, where tears overflow onto the cheek even without crying. This constant wetness can lead to eye irritation and a feeling of discomfort. The white part of the affected eye may appear red, and there might be a sticky, white, or yellowish discharge present.
The discharge can dry and form crusts on the eyelids, particularly noticeable upon waking. Swelling near the inner corner of the eye, close to the nose, can also occur and may be painful. Some individuals might experience blurred vision due to the excess tears on the eye’s surface. Recurrent eye infections, such as conjunctivitis or “pink eye,” are also common due to stagnant tears creating a breeding ground for bacteria.
Causes of Blockage
Several factors can contribute to a blocked tear duct in adults. Age-related changes are a common cause, as the tiny punctal openings that drain tears can narrow over time. Physical trauma to the face, such as a broken nose or injury near the eye, can cause bone damage or scar tissue that obstructs the drainage system.
Chronic inflammation or infection of the eye, tear drainage system, or nose can also lead to blockages, including conditions like chronic sinusitis or recurrent conjunctivitis. Growths like nasal polyps or tumors in the nose or along the tear drainage pathway can compress the duct. Certain medications, such as some eye drops for glaucoma, or cancer treatments like chemotherapy and radiation, are also potential causes.
When to Seek Medical Advice
If symptoms of a blocked tear duct persist for several days, worsen, or are accompanied by more severe indicators, consult an eye care professional. Persistent tearing that interferes with daily activities or continuous eye irritation warrants evaluation. If there is severe pain, fever, or any changes in vision, immediate medical attention is important. A doctor can accurately diagnose the cause of the blockage and rule out other underlying conditions, especially if a tumor is suspected.
Treatment Options
Treatment for a blocked tear duct in adults depends on the underlying cause and severity. For mild cases or those with associated infection, non-invasive approaches are considered. Antibiotic eye drops or ointments can be prescribed to manage bacterial infections and reduce discharge, though they do not directly clear the blockage. Warm compresses applied to the eye and gentle massage of the tear sac area, near the inner corner of the eye, can help promote drainage.
When non-invasive methods are insufficient, medical procedures are necessary. Dilation, probing, and irrigation involve widening the punctal openings and inserting a thin probe to clear the blockage, followed by flushing with a saline solution. For more persistent or severe blockages, surgical options like dacryocystorhinostomy (DCR) can create a new drainage pathway between the lacrimal sac and the nasal cavity, bypassing the obstruction. In some DCR procedures, stents may be temporarily placed to keep the new pathway open during healing.