Blockage of the tear duct

Description

When you have a blocked tear duct, your tears can't drain normally, leaving you with a watery, irritated eyes. The condition is caused by a partial or complete obstruction in the drainage system of the tear.

A blocked tear duct is common in newborns. The condition usually gets better without any treatment during the first year of life. In adults a blocked tear duct may be due to an injury, an infection, or rarely, a tumor.

A blocked tear duct is almost always correctable. The treatment depends on the cause of the obstruction, and the age of the person affected.

Symptoms

The symptoms of a blocked tear duct include:

  • Excessive tearing
  • Redness of the white part of the eye
  • Recurrent eye infection or inflammation, known as pink eye
  • Painful swelling near the inside corner of the eye
  • The formation of crusts on the eyelids
  • The mucus or pus in the eyelids and the surface of the eye
  • Blurred vision

When to see a doctor

Consult your health care provider if you tear constantly for several days or if your eye is repeatedly or continuously infected. A blocked tear duct may be caused by a tumor pressing on the system of the tear drainage. The early identification of the tumor can provide more treatment options.

Causes

Blocked tear ducts can occur at any age, from birth to adulthood. The causes are:

  • Congenital obstruction. Many babies are born with a blocked tear duct. The system of the tear drainage may not be fully developed, or there may be a conduit of abnormality. Often a thin tissue membrane is maintained above the vent that leads to the nose, called the nasolacrimal duct.
  • Age-related changes. With age, the small openings that drain tears, called puncta, you can get more narrow, causing the crash.
  • Infection or inflammation. Long-standing infection or inflammation of the eyes, tear drainage system or of the nose can cause your tear ducts to become blocked.
  • Injury or trauma. An injury to the face can cause damage to the bones or scars near the drainage system, which affect the typical flow of tears through the ducts. Even small particles of dirt or loose skin cells lodged in the duct can cause an obstruction.
  • The Tumor. A tumor in the nose or in any location along of the tear drainage system can cause an obstruction.
  • Drops for the eyes. Rarely, long-term use of certain medications such as eye drops used to treat glaucoma, can cause a blockage of the tear duct.
  • Cancer treatments. A blocked tear duct is a possible side effect of the medicine, chemotherapy and radiation therapy for cancer.

How the system works in the tear drainage

The lacrimal glands produce most of their tears. These glands are located on the inside of the upper eyelids, above each eye. Normally, the tears flow from the lacrimal glands on the surface of your eye. The tears drain through the openings called puncta in the inner corners of the upper and lower eyelids.

The puncta lead to small channels called canaliculi. Canaliculi move the tears into a sack to a deposit on the side of the nose is called the lacrimal sac. From there, the tears run through the nasolacrimal duct and drain into your nose. Once in the nose, the tears are reabsorbed.

A blockage can occur at any point in the system of the tear drainage, from the point of his nose. When that happens, your tears do not drain properly, giving watery eyes and increase the risk of eye infections and inflammation.

Risk factors

Certain factors increase the risk of developing a blockage of the tear duct:

  • Age. Older adults are at higher risk of developing blocked tear ducts due to age-related changes.
  • Chronic eye inflammation. If your eyes are constantly irritated, reddened and inflamed, you are at greater risk of developing a blockage of the tear duct.
  • The previous surgery. Above the eye, eyelid, nasal or sinus surgery may have caused some scars in the duct system, possibly resulting in a blockage of the tear duct later.
  • Glaucoma. Anti-glaucoma medications are often used topically in the eye. If you have used these or other topical medication to the eyes, you are at greater risk of developing a blockage of the tear duct.
  • Previous cancer treatment. If you have had radiation or chemotherapy to treat cancer, especially if the radiation was focused on the face or the head, you are at greater risk of developing a blockage of the tear duct.

Complications

Because your tears are not draining the way it should be, the tears that remain in the drainage system is watertight. This promotes the growth of bacteria, viruses, and fungi, which can lead to frequent infections of the eyes and inflammation.

Any part of the tear drainage system, including the transparent membrane on its surface of the eye known as the conjunctiva, can become infected or inflamed due to a blockage of the tear duct.

Prevention

To reduce your risk of developing a blockage of the tear duct, later in life, obtain an indicator of treatment of ocular inflammation or infections. Follow these tips to avoid infections in the eyes, in the first place:

  • Wash your hands carefully and often.
  • Try not to rub your eyes.
  • Replace your eyeliner and mascara on a regular basis. Never share these cosmetics with others.
  • If you wear contact lenses, keeping them clean according to the recommendations provided by the manufacturer and your ophthalmologist.

Blockage of the tear duct

Diagnosis

To diagnose your condition, your doctor will talk with you about your symptoms, examines your eyes and does a few tests. Your healthcare provider will also examine the inside of the nose to determine if any structural disorders of your nasal passages are causing an obstruction. If your doctor suspects a blocked tear duct, can undergo other tests to find the location of the obstruction.

The tests used to diagnose a blocked tear duct include:

  • The tear drainage test. This test measures how quickly your tears are the drainage. A drop of a special dye is placed on the surface of each eye. You may have a blockage of the tear duct if after five more minutes of the dye is still on the surface of your eyes.
  • Irrigation and probing. Your provider can flush a saline solution through your drainage system, tear to check how well it's draining. Or a thin instrument can be inserted through the small drainage holes in the corner of your lid, called puncta, to see if there are obstructions. In some cases, this search can even correct the problem.
  • Eye imaging tests. For this procedure, a contrast dye is passed from the point in the corner of the cover, through its system of tear drainage. After X-rays, computed tomography (CT) or magnetic resonance imaging (MRI) is used to find the location and cause of the obstruction.

Treatment

Your treatment depends on the cause of the obstruction of the tear duct. You may need more than one approach to fix the problem. If a tumor is the cause of your blockage of the tear duct, the treatment will focus on the cause of the tumor. Surgery may be performed to remove the tumor, or to your healthcare provider may recommend the use of other treatments to reduce its size.

  • The medication to fight the infection. If your doctor suspects that an infection is present, antibiotic eye drops or pills may be prescribed.
  • Wait and see, or massage.Babies who are born with a blocked tear duct is often recover without treatment. This can happen when the drainage system matures during the first few months of life. Often a thin tissue membrane is maintained above the vent that leads to the nose, called the nasolacrimal duct. If your baby's blocked tear duct does not improve, your baby's health care provider can teach you a special technique of massage to help open the membrane. If you have had a facial injury that caused the blocked tear ducts, your healthcare provider may suggest waiting a couple of months to see if the condition does not improve as your injury heals. As the swelling goes down, the tear duct can be unlocked by your own account.
  • The dilation, probing and washing.For babies, this technique is performed under general anesthesia. The provider extends the tear openings with a special expansion instrument. A thin tube is inserted through the puncta and in the system of the tear drainage. For adults with partially narrowing of puncta, your provider may dilate the puncta with a small probe, and then empty the tear duct. This is called irrigation. Irrigation is a simple outpatient procedure which often provides at least a temporary relief.
  • The placement of stents or intubation. This procedure is usually performed under general anesthesia. A thin tube of silicone or polyurethane, is passed through one or both puncta in the corner of your eyelid. These tubes then pass through of the tear drainage system in your nose. A small loop of tubing will remain visible in the corner of his eye, and the tubes are usually left in for about three months before they are deleted. Possible complications include inflammation of the presence of the tube.
  • The balloon catheter dilatation. If other treatments have not worked or the obstruction of the return, this procedure can be used. It is usually effective for infants and young children and can also be used in adults with a partial block. In the first place, a general anesthesia is delivered. Then, the provider of wire of a tube, called a catheter, through the blockage of the tear duct in the nose. The tube has a deflated balloon at the tip. The balloon is then inflated and deflated a few times to open the lock.

Wait and see, or massage. Babies who are born with a blocked tear duct is often recover without treatment. This can happen when the drainage system matures during the first few months of life. Often a thin tissue membrane is maintained above the vent that leads to the nose, called the nasolacrimal duct. If your baby's blocked tear duct does not improve, your baby's health care provider can teach you a special technique of massage to help open the membrane.

If you have had a facial injury that caused the blocked tear ducts, your healthcare provider may suggest waiting a couple of months to see if the condition does not improve as your injury heals. As the swelling goes down, the tear duct can be unlocked by your own account.

The dilation, probing and washing. For babies, this technique is performed under general anesthesia. The provider extends the tear openings with a special expansion instrument. A thin tube is inserted through the puncta and in the system of the tear drainage.

For adults with partially narrowing of puncta, your provider may dilate the puncta with a small probe, and then empty the tear duct. This is called irrigation. Irrigation is a simple outpatient procedure which often provides at least a temporary relief.

Surgery

The surgery that is commonly used for the treatment of blocked tear ducts is called dacryocystorhinostomy (DAK-ree-oh-sis-toe-rye-nohs-tuh-me). This procedure opens the way for the tears out of his nose again. You'll be given a general anesthesia or local anesthesia if it is performed as an outpatient procedure.

The steps in this procedure vary, depending on the exact location and extent of the obstruction, as well as your surgeon's experience and preferences.

  • External. With external dacryocystorhinostomy, the surgeon makes an incision in the side of the nose, near the lacrimal sac. After you connect to the lacrimal sac to the nasal cavity and the placement of a stent in the new gateway, the surgeon closes the incision of the skin with a couple of stitches.
  • Or endoscopic endonasal. With this method, the surgeon uses a microscope camera and other small instruments are inserted through the nasal opening to your duct system. This method does not require incision so that it does not leave a scar. But the success rates are not as high as with the external procedure.

After the surgery you are going to use a decongestant nasal spray and eye drops to prevent infection and reduce inflammation. After 6 to 12 weeks, you'll return to your provider's office for removal of the stents are used to keep the channel open during the healing process.

Preparing for your appointment

You can start by seeing your primary health care provider. Then, you may be referred to a doctor who specializes in the treatment of disorders of the eyes, called an ophthalmologist. In some cases, your eye doctor can refer you to someone who specializes in plastic surgery ophthalmic eye.

Here's some information to help you prepare for your appointment.

What you can do

Before your appointment, make a list of:

  • The symptoms that I had, including those that may seem unrelated to the reason for which you scheduled the appointment.
  • All the drugs, vitamins, and supplements you are taking, including dosage.
  • Drops for the eyes that you have been taking.
  • Questions to ask your health care provider.

By an obstruction of the tear duct, some basic questions to ask include:

  • What is the most likely cause of my symptoms?
  • There are other possible causes?
  • Do I need any tests?
  • How long will my condition in the past?
  • What treatments are available, and which do you recommend?
  • What side effects can I expect from treatment?
  • It is this condition related to another medical condition?
  • If I don't have anything to do to correct this problem, what are the risks to my vision?
  • Do you have any brochures or other printed material that I can take with me? What sites do you recommend?

What to expect from your doctor

Your provider is likely to ask a series of questions, such as:

  • When did your symptoms begin?
  • Do you feel that your symptoms all the time, or come and go?
  • Does nothing to alleviate their symptoms?
  • We have used eye drops to this problem?
  • Have you had any previous surgery of your eyes or eyelids?
  • You have had a facial trauma, injury, radiation treatment or surgery?
  • Have you ever had any of the conditions of the facial nerve, such as Bell's palsy?
  • Do you have a health problem, like diabetes or long-disorders of the skin such as atopic dermatitis?
  • Have you ever been diagnosed with a thyroid disorder?
  • Do you wear contact lenses? Have used the contacts in the past?
Symptoms and treatment of the obstruction of the tear duct