Blocked tear ducts cause excessive tearing and eye irritation when your tears cannot drain normally. Typically, tears drain out of small holes in the corner of your eye, and then pass through tiny tubes into the nose to be eliminated. A blockage anywhere in this drainage system will cause tears to back up and linger on the eye. This may cause eye infections, blurry vision, pain and bloody tears. Blocked tear ducts in adults are usually caused by infection, inflammation, tumor or injury. The best treatment will depend on the cause of the blockage.
The first step in treating a blocked tear duct is determining the underlying cause. If the blockage is caused by infection, your doctor will likely prescribe antibiotics. Warm compressed may temporarily relieve discomfort caused by the blocked tear duct. If the blockage is caused by a tumor, it will need to be medically treated or surgically removed. Facial injuries may cause swelling that temporarily stops up your tear drainage system. Once the underlying problem has healed, the tear drainage system will often start working properly on its own.
Minimally Invasive Treatments
Minimally invasive treatments can be successful for partial blockages or narrowing of the tear ducts. Dilation and irrigation is a procedure that can be done in a doctor's office. Tear ducts are widened with a special instrument and flushed out with saline. Balloon catheter dilation is done under anesthesia and requires the doctor to thread a tiny tube with a deflated balloon on the end up through the nose and into the tear drainage system. The balloon is then inflated with a pump to widen the tear drainage tubes. Stenting is also done under anesthesia. A tiny silicone tube is inserted through the drainage holes in the eye down through the length of the drainage system into the nose. These tubes are left in for 3 to 6 months to prop open the drainage system. There is a risk of inflammation around the tube and a little bit of tubing remains visible in the corner of the eye, though most people aren't bothered by it.
Surgery to treat a blocked tear duct can be performed under general anesthesia or a local, and is usually done on an outpatient basis. The normal drainage system is bypassed and a new drainage system is created using tiny silicone tubes. The tubes are left in place for up to 6 months to allow tissues to heal and create a new drainage system. Tubes are later removed through an open incision on the side of the nose in a procedure called an external dacryocystorhinostomy. This open procedure has the highest success rate for this type of blocked tear duct surgery. A closed procedure can also be done, in which tiny instruments are inserted through the nose to create the new drainage system. Risks include bruising, bleeding, infection and swelling. Sometimes, scar tissue forms that blocks the new drainage system and the procedure has to be repeated.
- TEInsight: Endoscopic Dacryocystorhinostomy in the Treatment of Nasolacrimal Duct Obstruction
- Acta Otorhinolaryngologica Italica: Posterior Lacrimal Sac Approach Technique Without Stenting in Endoscopic Dacryocystorhinostomy
- American Society of Ophthalmic Plastic and Reconstructive Surgery: Dacryocystorhinostomy--Creating a New Tear Drain