Eyes - blocked tear duct

The eyeball is kept moist and healthy by a thin film of tears that is continuously produced by the lacrimal gland, which sits beneath the upper eyelid. Each time you blink, tears are swept towards the inner corner of the eye and drained through two tiny tubes called the lacrimal canaliculi. From there, tears pass into the nasolacrimal sac, then down the nasolacrimal duct into the nose and, finally, to the throat to be swallowed.

A blockage at any point along this tear drainage system is known as a blocked tear duct, or dacryostenosis.

Symptoms of a blocked tear duct#

Symptoms of a blocked tear duct can include:

• A watering eye, with tears running down the face
• A discharge of pus
• Crusted mucus along the eyelashes
• Increased likelihood of eye infections

Causes of a blocked tear duct#

Some babies are born with a blockage within the tear duct system, usually in the nasolacrimal duct. This happens when the thin membrane that seals the duct before birth fails to open at birth or soon after (congenital dacryostenosis).

A range of conditions and events can cause acquired dacryostenosis, including:

• Thickening of the lining of the tear duct with age, which is the most common cause in adults and can eventually lead to blockage
• Chronic nose infections, such as chronic sinusitis, which may irritate the tissues and form scars that block the system
• Nose trauma, such as a broken nose, where scar tissue may block the injured duct
• Inflammation of the lining of the tear duct
• Conjunctivitis (inflammation of the thin membrane covering the eye)

In rare cases, the tear duct system can become infected and blocked, especially after some viral infections.

Diagnosis of a blocked tear duct#

A blocked tear duct is diagnosed using a number of tests, which may include:

• A physical examination, including your medical history
• An ophthalmic examination, to check for other possible causes
• Tests of tear drainage. For example, a special fluid is flushed into the affected tear duct opening; a blockage is suspected if you cannot taste the fluid in your throat.
• Imaging of the tear duct area, such as an x-ray, CT scan, or a dacryocystogram (an x-ray taken after a dye is introduced into the duct)

Treatment of a blocked tear duct#

A dacryocystorhinostomy (DCR) is an operation on the tear drainage pathway that helps improve the flow of tears from the eye to the nose. It is usually performed when there is a blockage in the main tear duct between the eye and the nose (the nasolacrimal duct) that has caused the eye to water and sometimes become infected. It is also sometimes performed when there is a partial blockage, to improve tear drainage.

Key points#

• The symptoms can include a pus-like discharge.
• A range of conditions and events can cause acquired dacryostenosis.
• Symptoms of a blocked tear duct can include an increased likelihood of eye infections.

Where to get help#