Tear Duct Issues: Signs, Symptoms, Treatments & Causes
Your eyes are constantly bathed in tears. Tears help fight infection, lubricate the eye and carry oxygen to the cornea, which has no blood vessels. They even aid in vision by helping light entering the eye to focus on the correct part of the retina.
Tears are composed of two main substances: The water part and the fat or lipid part. These two are produced by two different types of glands in the eye and do not mix until they are released there.
Tears remain on the eye for some time and then drain from them through the puncta, two tiny holes in both the upper and lower lids. From the puncta, tears flow into two short channels called the canaliculi and then into the lacrimal sac.
From that point, the nasolacrimal duct, called the tear duct, takes over, and tears then flow through the tear duct and then down the back of the nose, to the throat, and eventually into the stomach.
If the tear duct becomes clogged or dysfunctional, this process is disrupted, causing symptoms like inflamed, irritated, red, and watery eye or eyes. A blocked duct can occur in either eye or both eyes. Often people confuse the symptoms of a blacked tear duct with those of blepharitis. Blocked tear ducts have to do with fluids on your eyes, while blepharitis is an issue with your oil glands.
Causes of Blocked Tear Ducts
As many as 20 percent of babies are born with a blocked tear duct, called dacryostenosis. In medical terminology, stenosis means there is an abnormal narrowing of a body part.
Dacryostenosis can occur in newborns because a membrane sealing the tear ducts before birth fails to open and clear away. This eye problem is usually self-limiting, and the baby’s tear ducts typically function normally before six months.
Certain eye drops, particularly those used to treat glaucoma, can cause blocked tear ducts when used over time.
Some nose injuries, like a broken nose, can produce scar tissue that can alter the flow of tears through the ducts.
Conjunctivitis or pink eye caused by bacteria or a virus can also cause blocked tear ducts, primarily because of inflammation.
Polyps or small growths in the nose, sometimes linked to allergies, can press against the tear duct and cause it to narrow, restricting or blocking the flow of tears.
Repeated Sinus Infections
Chronic infections can leave scar tissue that can partially or totally block the tear ducts.
Normal aging and hormonal changes can cause the puncta to narrow, causing problems with tear drainage due to blocked tear ducts.
Symptoms of a Blocked Tear Duct
Blurry vision or other visual changes
Eye irritation, inflammation, and watering
Repeated eye infections
Eye swelling in the area near the nose
Possible thick eye discharge
These symptoms are not necessarily unique to a blocked tear duct. Only your eye care professional can make the correct diagnosis in your case.
Testing for a Blocked Tear Duct
Your doctor may use a number of tests to help diagnose or rule out a clogged tear duct.
A common method for this is the use of a special dye. The dye is instilled into the eye to see how fast it drains out.
Another test uses a tiny instrument to probe the tear duct to see where the blockage is. Some patients may require an MRI or CT scan to visualize the tear drainage system and find a block if there is one.
Adults and Blocked Tear Ducts
It’s not just babies that get blocked tear ducts. In fact, it’s not rare to see an adult with this problem. Aging can cause the ducts to narrow and become less functional, especially common among women over 40.
Chronic allergies, injuries, glaucoma, a history of eye or nose surgery, repeated sinus infections, and eye infections can all contribute to the causes of a blocked tear duct in an adult.
Babies and Blocked Tear Ducts
Up to one in five newborns may have blocked tear ducts, so the problem is relatively common in this age group. Although it may be highly distressing to parents, the condition is seldom serious and usually resolves of its own accord within months.
The child’s pediatrician may be able to recommend home care to relieve the problem. You can also talk to your eye care professional about your baby’s blocked tear ducts.
A unique form of massage on the tear ducts may help to clear them. Your eye care professional can teach you how to do this at home.
Treatment of Blocked Tear Ducts
Of course, treatment will vary depending on the cause. Some possible treatments include:
If your blocked tear duct is related to another problem, such as an eye infection, eye drops to treat the infection should clear the inflammation causing the swelling of the tear duct area.
Tear Duct Massage
This simple procedure is painless and can be done at home on either an adult or an infant. It’s a common and effective way to deal with tear duct blockage present at birth.
There are a number of office, outpatient surgery, or hospital procedures to help free up a blocked tear duct. One uses a special probe to dilate the puncta, and then the doctor flushes them out.
Another involves a catheter, which is a thin, flexible plastic tube with a tiny balloon attached to one end. The doctor then inflates the balloon, restoring the duct to normal size.
Another procedure involves inserting a tube and leaving it there for several months to help with tear drainage.
These procedures may require general anesthesia and some type of hospital stay, especially with infants.
Home Remedies for Blocked Tear Ducts
If you’ve consulted with your eye care professional and they have recommended home care for your blocked tear duct, there are a couple of home remedies you can try.
Warm compresses may help to relieve both the blocked duct and the discomfort. Use a clean, warm cloth and press it gently against the affected area. Ask your eye care professional how often you should do this.
Always wash your hands before touching your eye area. Use a different clean cloth for each compress for each eye. Launder the cloths before using them again.
Tear Duct Massage
This is especially useful for a blocked tear duct in an infant because it may help to dislodge any remaining prenatal membrane still blocking the tear duct:
- Wash your hands thoroughly
- Instill any prescribed drops into the eye
- With your index finger, gently stroke the sides of the nose
It’s best to ask your doctor to show you exactly how to do a tear duct massage.
Although a tear duct blockage isn’t typically serious, it can lead to other problems if left untreated. For one thing, the condition can promote the growth of viruses, fungi, and bacteria that could cause an eye infection.
Avoid any future problems with blocked tear ducts by washing your hands regularly before touching the eye area and training yourself to keep your hands away from your eyes, and resist any urge to rub at them.
If you wear contact lenses, follow your eye care professional’s lens care instructions strictly. Women should replace eye makeup regularly, especially tube mascara and liner.
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