Blocked Tear Duct

A blocked tear duct is a common condition in children that can cause excessive tearing and watery, irritated eyes.  If you or your child’s pediatrician are concerned about a blocked tear duct in your child, highly skilled pediatric ophthalmologist, Elena Nguyen, MD, at ENvision Eye Care in Foster City, California, offers expert diagnosis and treatment of blocked tear ducts.  Call ENvision Eye Care or request an appointment online today for a blocked tear duct evaluation.

What is a blocked tear duct?

Normally tears drain from the eye down the nose and throat through the tear duct (aka nasolacrimal duct).  If you look at yourself in the mirror, the openings of the tear ducts can be seen near the inner corners of the upper and lower eyelids.  They look like 2 small dots (one in the upper lid and one in the lower lid) and are called punctae.  The punctae connect via tube-like channels that meet at the bridge of the nose to form the lacrimal sac.  The lacrimal sac then drains into the nasolacrimal duct which transports the tears down the nose and into the throat.  

A blockage in the tear duct itself or along any part of this drainage pathway (aka the nasolacrimal system) prevents tears from draining normally.  This results in backflow of tears and discharge from the eye.

What causes a blocked tear duct?

The most common cause is a membrane at the end of the tear duct that is present in approximately half of newborn children.  This membrane normally disappears soon after birth.  Other causes of blocked tear ducts in children include:

• Absent punctae
• Narrow tear duct system
• Infection
• Incomplete development of the tear duct 

How is a blocked tear duct diagnosed?

Signs and symptoms of a blocked tear duct include tears welling up on the surface of the eye and overflowing onto the eyelashes, eyelids, and down the cheek, red/ swollen/ sticky eyelids, and yellowish-green discharge.  These symptoms can get worse if your child has allergies or a cold or is outside in the wind or cold.

A child with these symptoms can be evaluated by Dr. Nguyen in the office.  During the exam, Dr. Nguyen can perform certain tests to confirm the diagnosis and also rule out other less common but potentially vision-threatening causes of tearing in infants such as glaucoma.

How is a blocked tear duct treated?

In most cases (~90%), blocked tear ducts in infants will resolve on their own during the first year of life.  When there is concern for persistent blockage, Dr. Nguyen may recommend any of the following treatments:

• Tear duct massage
• Antibiotic eye drops
• Tear duct probing
• Balloon tear duct dilation 
• Tear duct intubation

If there is concern for a blocked tear duct in your child, schedule an eye exam with Dr. Nguyen by calling ENvision Eye Care or booking an appointment online today.