A tear duct is the drainage channel that carries used tears from the surface of your eye down into your nose. It’s part of a larger system called the lacrimal apparatus, which produces, spreads, and drains the thin film of moisture that keeps your eyes comfortable and clear. When people say “tear duct,” they’re usually referring to the nasolacrimal duct specifically, but the full drainage pathway involves several connected structures working together every time you blink.
How the Tear Drainage System Works
Tears are produced by glands above each eye and spread across the surface when you blink. Once they’ve done their job of lubricating and protecting the eye, they need somewhere to go. That’s where the drainage system takes over.
The journey starts at two tiny openings called puncta, one on each eyelid near the inner corner of your eye, close to your nose. Every time you blink, these puncta act like valves that pull used tears off the eye’s surface. From there, tears flow into narrow channels called canaliculi, which feed into a small pouch called the lacrimal sac, tucked into the inner corner of the eye socket. The lacrimal sac collects tears and funnels them into the nasolacrimal duct, which runs downward through bone and empties into your nasal cavity. This is why your nose runs when you cry: excess tears are literally draining into it.
Blinking Powers the Whole System
The drainage system isn’t passive. A small muscle attached to your eyelids creates a pumping action each time you blink. When this muscle contracts, it squeezes the tiny drainage channels shut from the outer side inward, pushing tear fluid toward the lacrimal sac. At the same time, it pulls the wall of the lacrimal sac open, creating suction that draws tears in. The whole sequence happens with a slight time delay from the outer to the inner corner of the eye, essentially milking tears along the pathway with each blink. This is why people who blink less frequently, such as during prolonged screen use, can experience watery or dry eyes: the pump isn’t cycling as often as it should.
Blocked Tear Ducts in Babies
About 6 percent of newborns are born with a blocked tear duct. The blockage usually happens because a thin membrane at the bottom of the nasolacrimal duct hasn’t fully opened by birth. You’ll notice persistent watering in one or both eyes, sometimes with a sticky discharge that crusts along the lashes.
Most cases resolve on their own without any procedure. In the meantime, a simple massage technique can help. With clean hands and short fingernails, place your fingertip where the upper and lower lids meet near the nose, then slide it downward about one to two centimeters with moderate, steady pressure. Repeat five times, twice a day. This creates gentle hydraulic pressure that can push open the membrane blocking the duct. If the blockage hasn’t cleared by around 12 months, a specialist may recommend a brief probing procedure to open the duct.
What Causes Blockages in Adults
In adults, blocked tear ducts develop for different reasons. The duct can narrow gradually with age as the tissue lining it thickens or becomes inflamed over time. Chronic sinus infections, nasal polyps, and facial injuries can also compress or scar the duct shut. Some eye drops used long-term and certain chemotherapy drugs are known to cause narrowing as well. Women are affected more often than men, possibly due to having a naturally narrower duct.
The main symptom is a persistently watery eye, often worse in cold or windy weather. You might also notice blurred vision from the excess tear film, or sticky discharge if the stagnant tears become infected.
Tear Duct Infections
When a tear duct is blocked, tears pool in the lacrimal sac instead of draining. That stagnant fluid becomes a breeding ground for bacteria, viruses, and fungi. The resulting infection, called dacryocystitis, causes pain, swelling, and redness in the inner corner of the eye near the nose. An abscess may form with visible pus, and some people develop a fever.
Chronic infections tend to be milder. You may just have persistently watery eyes and occasional tenderness without the dramatic swelling or fever. Left untreated over time, recurring infections can spread to the membrane covering the eye (the conjunctiva) or the surrounding tissue, creating a cycle of inflammation that makes the blockage worse.
How Blockages Are Diagnosed
A provider can often diagnose a blocked tear duct just by examining your eye and hearing your symptoms. One straightforward test involves placing a drop of fluorescent dye mixed with saline onto your eye. After five minutes, the provider checks with a special light. If the dye is still sitting on the eye’s surface instead of having drained away, that confirms a partial or complete blockage. Imaging may be used in more complex cases to pinpoint exactly where the obstruction is located.
Treatment Options for Adults
For mild or partial blockages, warm compresses and gentle massage of the lacrimal sac can sometimes improve drainage. Antibiotic drops or oral antibiotics treat active infections. But if the duct is fully blocked and symptoms are persistent, surgery is usually the most effective long-term solution.
The standard procedure creates a new pathway for tears to drain from the lacrimal sac directly into the nasal cavity, bypassing the blocked duct entirely. It can be done through a small incision on the side of the nose (external approach) or entirely through the nostril using a tiny camera (endoscopic approach). Both versions have high success rates. The external approach has historically been reported above 90 percent, and newer endoscopic techniques show comparable results, with some studies reporting anatomic success around 84 to 91 percent. Recovery typically involves a week or so of mild swelling, and most people notice their eye stops watering within days of the procedure.
Risks of Leaving a Blockage Untreated
A blocked tear duct isn’t an emergency, but ignoring it indefinitely carries real downsides. The constant pooling of stagnant tears promotes repeated infections that can damage surrounding tissue. Any part of the drainage system, including the conjunctiva, can become chronically inflamed. Over time this makes the blockage harder to treat and increases the chance of a more serious infection spreading beyond the eye. If you’ve had persistent tearing or recurring eye infections on one side, a blocked duct is one of the first things worth investigating.