Blocked Tear Duct

Blocked Tear Duct

The tear duct is responsible for draining fluid from the eye to the nose. The tear duct starts at the lacrimal punctum, which is located in the part of the eyelid nearest the nose, and finishes inside the nose itself with the nasolacrimal duct. When the tear duct is obstructed, fluid cannot be drained and, consequently, the patient suffers from epiphora (watering eyes) and repeated eye infections.

Blocked tear ducts can be congenital and are most common in babies whose tear duct doesn’t “break through” into the nose. In the majority of babies the problem is solved without intervention or after regular massages in the nose area where the tear duct flows. In a small percentage of cases where the obstruction persists, a probe of the tear duct may be carried out. This consists of inserting a small metal probe going from the lacrimal punctum to the mouth of the nasolacrimal duct in the nose which will open the duct and cure the problem.

In adults an obstructed tear duct can be down to several factors such as conjunctivitis, tissue stenosis due to ageing, or an injury. Once the tear duct has become obstructed in adults the solution is surgical with the most commonly used technique being dacryocystorhinostomy, which consists of creating a new duct to carry fluid from the lacrimal punctums in the eye to the nose circumventing the existing blockage.

This surgery can be carried out:

  • Externally (external dacryocystorhinostomy) with a small incision in the wing of the nose which is invisible to most people. This is the technique that gets the best results.

  • Through the endonasal duct (endonasal dacryocystorhinostomy) via the nostril.

  • By introducing a small laser probe into the lacrimal punctums (transcanalicular diode laser-assisted dacryocystorhinostomy). This technique has the advantage that an incision in the skin does not need to be made but has the disadvantage that the duct created between the eye and the nose is narrow.

In the majority of cases, surgery can be performed using a local anaesthetic and a sedative to make the process completely painless without the risks of a general anaesthetic. To ensure that the new tear duct remains impermeable following surgery, normally fine silicon tubes are initially inserted and then removed a few weeks after the operation.

The choice of treatment depends on the nature of each case. At Clínica Castilla all patients receive personalised care and we select the most appropriate technique for each case.