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In adults, a clogged tear duct will typically heal on its own unless it becomes infected. Learn about symptoms, causes, and treatment options
In adults, a clogged tear duct will typically heal on its own unless it becomes infected. You can open up a blocked tear duct with a combination of warm compress and massage. Babies, however, may require medical treatment.
If your blocked tear duct does not resolve on its own, consult your ophthalmologist.
What are symptoms of a blocked tear duct?
Tear ducts function primarily as a drainage system. When they become blocked, tears are unable to drain normally and accumulate in the eye, causing symptoms such as:
- Excessive tearing or watery eyes
- Irritation and dryness in the eyes
- Tenderness and redness near the inside corner of the eye
- Pus discharge
- Crusty buildup
- Poor or blurred vision
- Recurrent eye infections
- Fever
- Blood-tinged tears in rare cases
- Symptoms that worsen in certain weather conditions such as windy or cold days
11 causes of a blocked tear duct
A blockage can occur anywhere along the length of the tear duct. For example, it can occur at the punctum, which is the first part of the tear duct inside the eyelid, or it can occur in the lower part of the tear duct near the nose. Common causes of clogged tear ducts may include:
- Congenital blockage: Many babies are born with clogged tear ducts, possibly because their tear drainage system is not fully developed or abnormal. Sometimes a thin tissue membrane remains over the opening that empties into the nasolacrimal duct.
- Craniofacial abnormalities: Anomalies in the development of the skull and face, such as those seen in Down syndrome and other disorders, increase the likelihood of developing tear duct blockage.
- Age: With age, the punctual openings that drain tears tend to narrow and can lead to blockage.
- Chronic sinusitis: Chronic sinusitis can irritate and scar tissues, which can clog the tear duct system.
- Infections: The tear duct system can become infected and blocked due to viral, bacterial, or fungal infections.
- Injury: A facial injury can result in bone damage or scarring near the drainage system, disrupting the normal flow of tears through the ducts. Even small dirt particles or loose skin cells lodged in the duct can cause blockage.
- Polyps: Nose polyps, a growth from the nose's lining that affects some people with nasal allergies, can obstruct the tear duct system.
- Tumor: A tumor in the nose or anywhere along the tear drainage system can clog the system.
- Cancer treatment: Chemotherapy and radiation treatment may cause clogged tear ducts as a side effect.
- Eye drops: Long-term use of anti-glaucoma eye drops or other medications can lead to a blocked tear duct in rare cases.
- Previous surgery: Previous eye, eyelid, nasal, or sinus surgery may have caused scarring in the duct system, potentially resulting in a blocked tear duct later on.
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How is the cause of a clogged tear duct diagnosed?
Doctors may ask about your symptoms, examine your eyes, and run a few tests to determine the cause of your condition. They may also examine your nasal cavity to see if any structural problems in the nasal passages are causing an obstruction. If your doctor suspects a blocked tear duct, they may recommend additional tests to determine the location of the blockage. Tests include:
- Tear drainage test: This test measures how quickly your tears are draining. A drop of special dye is applied to the eyes. If most of the dye is still on the surface of your eye after 5 minutes, you may have a blocked tear duct.
- Irrigation and probing: A saline solution may be flushed through your tear drainage system to see how well it drains, or a probe may be inserted through the tiny drainage holes at the puncta to check for blockages. In some cases, this probing may even resolve a clogged duct issue.
- Eye imaging tests: A contrast dye is passed through the tear drainage system from the puncta, followed by X-rays, CT scans, or MRI scans to determine the location and cause of the blockage.
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What are treatment options for a clogged tear duct?
The best course of treatment for a blocked tear duct depends on the cause of the blockage:
- Congenital blockage: The standard approach is to simply wait it out because over 90% of babies born with a blocked tear duct will eventually develop a fully functioning drainage system. If the blocked tear duct still does not open, parents may gently massage around the baby’s face and eyes so that the membrane separates.
- Infection: If the blockage is caused by infection, antibiotic eye drops should resolve the issue within a few days. Use warm water and wet cotton balls to remove the dried and liquid pus from the eyelids.
- Injury: You may be advised to wait a few months to see if the blockage clears up as the injury heals. Tear ducts will most likely reopen on their own as swelling subsides.
- Tumor: Surgery may be used to remove the tumor, or other treatments may be used to shrink the size of the tumor.
If these remedies don’t work or the blockage is more serious, the following treatment options may be considered:
- Drainage: For babies, a thin probe is inserted into the drainage system to clear the obstruction. For adults, the tear duct can be flushed in an outpatient procedure.
- Balloon catheter dilation: A tube with a deflated balloon at one end is threaded through the nose. The balloon is then inflated and deflated until the blockage is removed.
- Stenting or intubation: A thin tube is inserted through the tear drainage system through an opening in the corner of the eyelid, then removed after the ducts have been propped open long enough for them to function on their own.
If none of these methods work to unclog the tear ducts, surgery is the only option left.
What is surgery for a clogged tear duct?
Surgery
Dacryocystorhinostomy opens up the nasal passageways and allows tears to drain properly from the nose. There are two main types of this surgery.
- External dacryocystorhinostomy: An opening is made on the side of the nose, close to the lacrimal sac. A stent is then inserted into the opening.
- Endoscopic dacryocystorhinostomy: Microscopic instruments are inserted through the nose into the ducts. While less invasive than an external dacryocystorhinostomy, this procedure may not be as effective.
After surgery, nasal decongestant sprays and eye drops may help prevent infection and reduce inflammation. After 6-12 weeks, you will need to return to the doctor's office for the removal of the stents that were used to keep the new channel open during the healing process.
Side effects
Following surgery, side effects may include:
Recovery
Dacryocystorhinostomy is a major procedure that involves breaking the bones on the side of the nose to remove the obstruction and creating a new passageway for the tears to drain. Recovery may take up to 90 days.
How can you prevent a clogged tear duct?
If your tears are not draining properly, it can encourage the growth of bacteria and result in infection. The following can help you prevent eye infections:
- Wash your hands frequently and thoroughly.
- Avoid rubbing your eyes.
- Replace your eyeliner and mascara regularly.
- Never share cosmetics with other people.
- Keep your contact lenses clean.
