Passionate about health, Alison is a freelance writer/researcher for clients working in nutrition, physiotherapy, and chiropractic.
Blocked Tear Duct?
If you have watery eyes, a painful swollen area at the inside corner of your eye, or suffer from recurrent eye infections, you just might have a blocked tear duct. Adults, children, and newborn babies can suffer from this condition. Read on to find out more about the symptoms and causes, whether surgery is necessary, and other treatment options.
Tears, Tear Glands, and Tear Ducts
Tears are vital to the health and function of the eye. They are produced in glands inside the upper eyelids, as shown in the illustration above. These lubricating tears flow over the surface of the eye, and unless we produce excess (crying, for example), they will normally drain through very tiny holes called puncta, which are found in the inside corners of both the upper and lower eyelids.1
Tears normally drain down through small channels and into a small reservoir, or lacrimal sac, and are reabsorbed by the body from here.
A blocked tear duct is not necessarily at the opening of the duct; it can occur at any point between the punta and the lacrimal sac.
Massaging Baby's Blocked Tear ducts
If your baby has "mucky" eyes and the pediatrician has checked your baby over, the video below has helpful advice on how to help to open the tear ducts gently.
Good advice is to do this while your baby is sleeping!
Take a clean finger—your ring or pinkie finger would be best—and gently place it in the nook beside the eye at the side of the nose, where the tear duct is, and gently massage in a counterclockwise direction. Skip to about the 1.33 section of the video below for a demonstration of this.
Cleaning a Baby's Sticky Eyes
In the meantime, whilst your baby has a blocked tear duct, the eyes will be gunky and sticky, particularly after sleeping. Go to the 3-minute mark on the video (above) for how to clean the baby's eyes with cotton balls and sterile water (you could use cooled, freshly boiled water for this).
- Using a clean cotton ball, dip into the cooled water and wipe gently from the inside corner out (never work back towards the nose).
- When you need to re-moisten the cotton ball, get a fresh one. NEVER dip this back into the water.
- Always use a fresh cotton ball for the other eye if this needs treating, too.
My top tip, learned from a friend in the US, who had a baby girl in 2016, is to buy a pack of Dr. Fischer's baby eye wipes for use when you are away from home. Her pediatrician recommended these for when she was out and about and not able to use the method outlined above for her baby's sticky eyes.
Dr. Fischer's baby eye wipes come in individual, sealed sachets (30 in a pack) and will not irritate sensitive eyes. She found them very effective. Thankfully, her baby's eye problems have now resolved, but she says she still keeps a couple in her purse, just in case.
What If the Baby's Blocked Tear Duct Does Not Resolve?
In 90% of infants or more, the problem will resolve. If not, though, surgery can solve the problem. Nasolacrimal Duct Probing 2 is a procedure that often resolves the problem. Sometimes a tiny tube or stent is inserted into the duct and left in place for around six months, after which time it is removed, and the duct is then open. Check out the video for a full explanation.
Confirming The Diagnosis of a Tear Duct Blockage for An Adult
Many people suffer from a blocked lacrimal duct (this is the medical term for a tear duct). Sometimes these resolve themselves—for example, if you have a heavy cold or a sinus infection, the linings of the drainage channels for your tears may become inflamed, leading to restriction of the flow of your tears and causing your eyes to water uncomfortably. These problems will resolve when the inflammation goes.
However, there are times when you should definitely see your doctor. If your eye has been watery for no apparent reason, you keep getting eye infections, or you have an irritated or sore eye, you should get this checked out.
In very rare cases, the cause could be a tumor. Whilst this might sound alarming, getting a swift diagnosis and early treatment will ensure the best possible outcome. 3
There are a couple of different tests that Doctors do that help them.
Fluorescein Dye Test
The first one you might come across is the Fluorescein dye test .4 This involves instilling a small amount of fluorescein solution into the space between your lower eyelid and eyeball (the conjunctival sac). Fluorescence from the tear film is measured and the rate of disappearance of this fluorescence gives a measure of the rate of drainage of tears.
The Drop Test
A newer test, the Drop Test, is more sensitive than the fluorescein one. It simply involves instilling a lukewarm solution of saline in the same way as the fluorescein dye above. It is left there for three minutes and then any remaining solution is removed and measured. The difference between the amount of saline solution instilled and the amount removed, gives a measurement of how much has been drained away by the tear duct.
Home Remedies for Blocked Tear Ducts
- Use a cotton washcloth wrung out after soaking in hot water as a compress over the eyes. Leave on for about five minutes at a time.
- Massage the internal corner of your eye as shown in the video treating babies with blocked tear ducts.
- Massage your eyelids clockwise and then counterclockwise for about half a minute.
- Pinch the bridge of your nose by placing the tip of your index finger on either side. Then run your fingers down the line of the bone on either side.
Whichever method you choose, repeat a few times each day.
Surgical Procedures for Blocked Tear Ducts
Two types of surgical procedure either from the outside or from the inside of the nose can be done to reroute the tear drain, making the drainage slightly higher up. This effectively turns the narrowed, partially blocked drainage tube into the equivalent of an "eight lane highway" so that effective tear drainage is restored.
Both types of surgeries are outpatient procedures although there can be some bruising and swelling after the procedure. Patients sometimes worry that the procedure has not worked as they still have tearing immediately after the surgery but this is due to the swelling and as this subsides, the tearing will diminish.
Once treated, the chances of the blockage coming back after treatment are small—fewer than 10% of patients have a recurrence.
Endoscopic Laser Assisted Dacryocystorhinostomy (ELA-DCR)
Endoscopic Laser-Assisted Dacryocystorhinostomy is a surgical procedure used for treating blocked tear ducts.5
The video below shows the procedure in some detail. It involves using an endoscopic laser inserted through the nose. If you are a bit squeamish, the video is quite graphic but does show how beautifully simple the operation is.
Patients can resume their normal lives and go back to work, etc., the very next day.
Nasolacrimal Duct Stone Removal
A "stone" forming in the Nasolacrimal duct, although rare, is another cause of a blockage in the drainage system. 6 The video on the right shows the procedure for removing one in a simple, endoscopic procedure performed through the nose.
Causes of Blocked Tear Ducts
Babies: 7 Many babies have blocked tear ducts when they are born, especially if they are born prematurely and the tear drainage system has not developed completely. Often this resolves very quickly; there might be a very thin membrane covering the drainage duct which usually sorts itself out by the time the baby is around eight weeks old. Sometimes these congenital tear duct blockages as they are also called, take longer to resolve but most go away by themselves by the time the child is a year old.
Treatment may be medically advised or elected by parents sooner than this.
In Adults: 8
Growing Older: Partial blockage of tear ducts often occurs as we get older, particularly in women. This is usually caused by a narrowing of the opening of the tiny puncta in the corners of the eye through which the tears drain.
This slows down the flow of tears down the normal drainage channel and may cause "teary eyes" where the excess overflows the lower lids. Partial blockage is the most common problem of aging, although a total blockage can also occur.
Trauma: Sports injuries or an accident to the nose or cheekbone can cause a blockage as can previous surgery for an eye problem. Ongoing or chronic infections affecting your eyes or nose can also be a cause.
Medications: Sometimes medications and treatments can cause blockages. This could be a medication you are taking for an eye condition, such as glaucoma, which involves the use of eye drops or ointment. If you are undergoing chemotherapy or radiotherapy for a cancer, blocked tear ducts could be a side effect of the treatment.
Tumors: There is another cause of tear duct blockages and although this is quite rare, it is a good reason for getting any problems checked out. Tumors can grow in the nose, sinus cavity, or in the lacrimal sac where tears collect to be reabsorbed. These can cause a blockage as they grow, and early treatment is the best action!
In researching this article I read extensively. I have updated my article (April 2017) to provide a numbered key to the articles that, in my opinion, provide the most helpful information on the topics covered.
Here are the articles referenced:
1. Blocked Tear Duct Symptoms and Causes. (February 11, 2016). Mayo Clinic. Accessed April 18, 2017.
2. Should My Baby Have a Probing Procedure? (November 20, 2015). University of Michigan. Accessed April 18, 2017.
3. Blocked Tear Duct in Adults. (September 27, 2015). Pain Information Center. Accessed April 18, 2017.
4. Dye Disappearance Test. (n.d.). WebMD. Accessed April 18, 2017.
5. Endoscopic Laser-Assisted Dacryocystorhinostomy. (June 13, 2015). Don Santiago MD. Accessed April 18, 2017.
6. Stones In The Lacrimal Gland. (August 12, 2008). Wiley Online Library. Accessed April 18, 2017.
7. Tear Duct Blockage in Babies. (April 16, 2014). Patient. Accessed April 18, 2017.
8. Blocked Tear Ducts: Causes in Adults. (n.d.). WebMD. Accessed April 18, 2017.
Author's note: Where the citation shows (n.d), this indicates that no publication date was shown on the article.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2013 Alison Graham
Alison Graham (author) from UK on June 18, 2018:
Hi Amy, thank you so much for sharing your experience with you daughter's blocked tear ducts. Please contact me as I would love to include the pictures you mention in my article as I think it would really help others to know what to expect when their child needs surgery for blocked tear ducts. Thank you again for your detailed account. Alison
amy eriksen from Edmonton Alberta Canada on June 16, 2018:
Just wanted to say thank you for this article and to share my story to help other parents who may feel worried abut their child.
I am a only parent to a beautiful 3.7 year old. When she was born both ducts were blocked. after 18 months the doctor finally decided they wouldn’t open on their own. My child had so many eye infections that eye antibiotics were a contestant companion for her. So he referred us to a surgeon for the gentle probing procedure. June 2016 she went to the hospital and had the probing done. Both eyes. I bawled from the moment their took her to the O.R. Until she came back and them cried even harder because I was not told or prepared for what I would see. My beautiful child literally looked like she went 10 rounds with mike Tyson. I kid you not, her eyes were so swollen and huge. That was a minor procedure and they only used a mask to put her to sleep. No general anesthesia that time. She was back to her Normal self within 8 hour lol 2 days? And all she had was tiny black eyes left. Her eyes were great for about a week and then the left eye started tearing and becoming infected every second week. right eye stayed open thank god all the way until today. They tried to suggest a second probing? I said not a chance. I wanted this fixed because In the previous year she has literally not had more than 2 days every two weeks where she did not need antivirus on her left eye. It was that bad. Finally Last week on Wednesday June 13th 2018, She is 3.7 years old, she went in for a eye stent surgery on her left eye. This time I knew what to expect so no tears. She had a general. But at her age the General is given through a mask not a needle like adults. the surgery took less than 30 mins and she was back in my arms in under a hour. when I saw her I swear you wouldn’t even know she had surgery! No bruising no puffy nothing!!!! Naturally she was fussy saying her eye hurt until I gave her my iPhone to watch kids YouTube haha we literally were out of the hospital a hour after the surgery was over. The stent is still in place and no tearing and no goop anymore. I have pictures from both surgeries before and after if anyone wants to see them to have a idea of what to expect. If allowed by the owner of this webpage feel free to comment and I will send my Facebook link for you to add me and I’ll show you :) My advice? Is don’t allow the doctors to push for a second probing as you do have a choice. We as parents are the ones paying for all this. A second probing if the first one fails is a waste of money. my child was so thrilled to go to the hospital as well as I told her she will get a needle it might hurt and she will go to sleep and when she wakes up Her eye will be fixed! No major details lol and finally? No more fights or struggles to put in ointment 4 times a day. Yes stronger drops for 4 weeks but only twice a day. To keep the stent and duct free from infection. But that’s such a small price for the freedom and drastically improved quality of life for my child.
Alison Graham (author) from UK on May 10, 2018:
Shelby, thank you for your comment. Your question regarding bruising is outside the remit of this article on blocked tear duct treatment and regrettably, is not one I am qualified to answer. I'm sure it must be worrying for you and probably the best thing to do is to see your own primary health care provider to give you peace of mind and correct advice. Hope you feel better very soon.
shelbylawton on May 09, 2018:
This was a good article, good information. Thank you. I asked a question , on the " ask a question', as I have an issue with bruising in that area ( left side of eye, on inside of nose ) that I am trying to treat. Thank you.
Alison Graham (author) from UK on May 04, 2013:
Sorry to hear you have suffered from this problem with your tear ducts Scribenet. Thanks for sharing your experience here.
Maggie Griess from Ontario, Canada on May 04, 2013:
Good information! I have had blocked tear ducts and it can get painful.