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A blocked tear duct is a clog in the eye’s tear drainage system. When tears cannot drain correctly, they well up on the eye, causing watery, irritated eyes. This condition is also known as a nasolacrimal duct obstruction.
How the Tear Drainage System Works
Your tears lubricate and protect your eyes. Tear glands, located in and around your upper eyelids, produce these tears.
Tears flow from the tear glands down the eye’s surface. They then drain into the tear ducts, or puncta, which are inside the corners of your eyes. From there, tears travel through small tubes called lacrimal canals. These canals lead to lacrimal sacs at the inner corners of your eyes before draining through the side of the nose.
If the drainage system is healthy, the tears either evaporate or are absorbed naturally. When a blockage occurs at any point along this path, tears back up. This often results in watery eyes and other symptoms.
What Causes a Clogged Tear Duct?
A clogged tear duct can be bothersome and can happen for several reasons in both adults and children.
Anatomy and Development
The blockage can be present from birth. This is known as a congenital blocked tear duct. Between 6 and 20 percent of babies are born with this condition. The blockage usually resolves on its own within a few months as the baby’s tear drainage system fully develops.
Punctal stenosis, a narrowing of the lacrimal canals, is another anatomical cause. These canals carry tears from the tear ducts to the lacrimal sacs. People around age 40 and older, especially those with eyelid inflammation (blepharitis), can develop this narrowing. People with disorders affecting the skull and face development, such as Down syndrome, have a greater likelihood of developing blocked tear ducts.
Injury and Infection
Eye infections, such as pink eye (conjunctivitis) or infections from contact lenses, can cause swelling. This swelling can close off the tear ducts and lead to a blockage. If bacteria get into the tear drainage system, an infected tear duct, called dacryocystitis, can occur.
Trauma to the eye or nose, such as a broken nose, can produce swelling and scars. These scars can obstruct the tear ducts. Chronic nasal infections like sinusitis can also cause scarring that blocks the tear duct system.
Medical Factors
Some medical treatments can cause tear ducts to swell and become blocked. Certain glaucoma eye drops or specific cancer treatments have been shown to cause swelling in the tear drainage system. Allergies can also cause polyps, or small bumps, to form in the nasal lining. The polyps push on the tear duct, causing a blockage. Nasal lining swelling caused by allergies can also obstruct the tear ducts.
What Are the Symptoms of a Blocked Tear Duct?
Symptoms of a blocked tear duct can become more noticeable after a cold or sinus infection. You might also see symptoms worsen in direct sunlight, in low temperatures, or in windy weather.
Some blocked tear duct symptoms can also signal another eye condition or infection. It is necessary to see an optometrist or ophthalmologist for an exam to know the true problem.
Symptoms of a blocked tear duct or infected tear duct include:
- Watery eyes (excessive tearing).
- Swelling, redness, or pain around the nose or at the inner corner of the eye.
- Redness of the whites of your eyes.
- Mucus discharge from the eye that might form a crust.
- Recurring eye infections.
- Blurry vision.
- Blood-tinged tears.
- Fever.
How Are Blocked Tear Ducts Treated?
Treatment for a blocked tear duct depends on the cause. The blockage can often be corrected with non-surgical or surgical methods.
Your eye doctor might suggest one or more of these treatments:
Observation and Massage
A blocked tear duct sometimes fixes itself. For example, a baby’s congenital clogged eye duct usually clears within a few months as the tear drainage system matures. For babies with this condition, your eye doctor might show you a gentle massage technique to encourage the ducts to open and flow.
Medication
If your eye doctor suspects an infection is present, they may prescribe antibiotics. These can be antibiotic eye drops or oral medication to reduce the infection and swelling.
Non-Surgical Procedures
- Dilating, Probing, and Flushing – A healthcare provider uses a small probe to enlarge the small or clogged tear duct openings. The duct may then be flushed out with a saline solution. For children, this procedure may be performed under anesthesia.
- Balloon Catheter Dilation – A thin catheter with a deflated balloon is inserted into the blocked tear duct. The balloon is inflated and deflated repeatedly to open the passageway. This procedure is typically done under anesthesia.
- Stenting (Intubation) – A thin tube, or stent, is threaded through the tear drainage system from the tear duct into the nose. This tube holds the duct open. This procedure is also typically performed under anesthesia.
Surgical Treatment
Dacryocystorhinostomy, often called DCR, is a surgical solution. This surgery creates a new pathway between the tear ducts and the nose for tears to drain. DCR is typically performed under anesthesia.
Taking Care of Your Eye Health
Tears are significant part of your eye health. They keep your eyes lubricated to prevent dry eyes, protect against irritation and infection, and help keep your vision clear.
Getting regular comprehensive eye exams will help maintain the health of your tear drainage system and your eyes overall. Make sure to see an eye doctor whenever you experience vision problems, eye discomfort, or suspect you have an eye issue.
