Blocked tear ducts

How do tears work?

Tears clean the eyes and keep the surface of the eye moist. They are produced all the time by the tear glands (lacrimal glands) and flow down across the surface of the eye. They then drain through a small opening (punctum) near the corner of the eye into the tear sac (lacrimal sac). From there, they flow down a tube called the tear duct (nasolacrimal duct) into the nose and throat.

What is a blocked tear duct?

A tear duct that is blocked stops the flow of tears from the eye down into the nose. It can affect one or both eyes.

Blocked tear duct

Symptoms of blocked tear ducts

• Your child will have wet eyelashes or extra tears. Since the tears cannot drain out of the tear duct, they spill over the lashes, often onto the cheeks.
• Your child's eyelids may stick together with mucus, especially in the morning. Mucus is a sticky liquid that is normally dissolved in the tears. When tears do not flow well, however, the mucus stays on the outside of the eye. This mucus is normal. It is not the same as pus (a yellowish or greenish liquid), which is a sign of an infection.
• Your child may often have a red eye. This is caused by infections, which are more common when tears do not drain properly.

Extra tears do not always mean the tear ducts are blocked

Extra tears are not always caused by blocked tear ducts. If your child has extra tears, an eye doctor should check your child's eye(s).

Causes of a blocked tear duct

A blocked tear duct usually occurs when the nasolacrimal duct fails to open at its lower end in the nose.

The condition can be congenital (it is present at birth) or acquired (it develops later in life). A congenital blocked tear duct affects about one in 25 babies.

Treatments for blocked tear ducts

There are different treatments for blocked tear ducts. Your doctor will explain which treatment is best for your child.

Medical treatments include massage and antibiotics for any infections. Since nine in 10 infants will get better on their own by the age of 1, your doctor might suggest to watch and wait for the blockage to resolve on its own. If treatments do not work or the blocked tear ducts do not resolve on their own, your doctor will recommend surgery (an operation).

Massaging the eye

Gently rubbing (massaging) the lacrimal sac will often help open the tear duct. You will usually need to do this four to six times a day. Your doctor will explain how to massage the lacrimal sac.

Antibiotics

If your child's eye discharge becomes thicker and is yellow or green in colour, they may have an infection. If your child has an infection, the doctor may prescribe antibiotic drops or ointment. Make sure you apply the ointment or eye drops correctly.

Surgery for blocked tear ducts

If medical treatments have not worked after several months, your child may need surgery. Your child might also need surgery if the lacrimal sac is infected and the skin between the eyeball and the side of the nose is red and swollen.

Different types of surgery are available. Your doctor will discuss with you which surgery is best for your child. This will be based on your child's age and how serious the blockage is. Your doctor will also discuss the risks involved with any surgery.