Blocked Tear Duct

Dr. Orathai Chansanti , Ophthalmologist

After birth, the infant’s lacrimal duct may be blocked up, but it usually clears out within a first few weeks. If the obstruction fails to resolve, it may leads to a condition called “Blocked Tear Duct”, which found around 1.75 to 6% of full-term infants. This happens because the end of the lacrimal duct in the sinus canal is much narrowed.

What are the symptoms of Blocked Tear Duct?
Primary symptoms are over flow of tears, like after crying. Some people may have eye inflamed together with having secretions. This disease is often found after birth, and improved by using the eye drops. Unfortunately, it’s not completely cured. The eyes with more secretions will have more chances to increase diseases in the lacrimal sac and this will lead to inflammation and become abscess under the lacrimal sac. Blocked tear duct may be at one or both eyes.

This picture shows blocked tear duct in a child. The secretions are at the edge of the eyelid and eye lashes.

This picture shows blocked tear duct in a child, that is infected and spreading to the lacrimal sac, finally caused inflammation, pain, swelling, redness and abscess.

In case of suspected a blocked tear duct, this should be examined by an ophthalmologist for diagnosis. The simple method is the dye disappearance test, The examiner instills fluorescein into each eye and then observes the tear. Persistence of dye after 5 minutes indicates a blocked tear duct. The other method is using saline or sterile water irrigation. Reflux of irrigation fluid indicates a blocked tear duct.

When a blocked tear duct is diagnosed, the doctors normally advise to gently massage in the area of lacrimal sac. The correct massage manner is important, it will help to open the blockage and clear out the lacrimal duct. If the obstruction persists for a long time, this may leads to infection. The massage should be done every day and massage several times a day for 5 - 10 minutes. In case of secretions remained, antibiotic eye drops will be occasionally used.

Most obstructions open spontaneously within 4 - 6 weeks after birth. Approximately 90% of blocked tear duct resolve in the first year of life.

Other treatments, such as probing and intubation, will be considered in these followings:
- The infection is recurrent.
- The obstruction persists after 1 year of age.

Picture shows blocked tear duct in a child. The infection spread to the lacrimal sac causes an abscess.

If there is no recurrent infection, this could be waiting until 1 year old. Because most of this condition can resolve spontaneously and the dilating procedure may require general anesthetic.

The success rate of the procedure is depending on the age. At 1 to 1.5 years of age, success rate is at 77 %, whereas at 1.5 to 2 years of age, the success rate is decreased to 54 %.

If the treatments are unable to resolve the symptoms, surgery may be considered for a blocked tear duct. It is usually done when the bone socket is mature. An ophthalmologist will consider case by case.