Tear Duct Obstruction

Tear Duct Obstruction

What is Tear Duct Obstruction?

Normally tears are produced by the tear gland, which is hidden under our upper eyelid, and drained into the nose by tear ducts that that are found on the nasal side of the upper and lower eyelids. If any part of the tear duct is blocked, tears will accumulate at the lid margin and start to overflow on to the cheek. The most common cause of tear duct obstruction in children is the failure of a membrane at the end of the tear duct (the valve of Hasner) to open normally around the time of birth. Other causes of a blocked tear block include a narrow tear duct system, nasal bone that blocks the tear duct entering the nose, infection, or absent puncta in the upper or lower eyelids.

What are the Signs and Symptoms of Tear Duct Obstruction?

When there is tear duct obstruction, tears can accumulate on the surface of the eye and overflow onto the eyelashes, eyelids, and down the cheek. The eyelids can become irritated, swollen, and matted with yellowish-green discharge. Significant obstruction can lead to a serious infection of the tear duct system known as dacryocystitis.

How is Tear Duct Obstruction Diagnosed and Treated?

A history of tearing and discharge at a very early age is usually indicative of a blocked tear duct; however, it is important for the pediatric ophthalmologist to rule out congenital glaucoma, which may present with tearing as well. A test called the dye disappearance test can be done to confirm the presence of a blocked tear duct. Thankfully, most blocked tear ducts resolve spontaneously usually by the age of one. Typically it is recommended that parents massage the tear duct, which can lead to resolution of the obstruction. If the obstruction still persists at one year of age, probing of the tear duct with possible intubation can be performed.

Source: American Academy of Pediatric Ophthalmology and Strabismus