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Blocked Tear Duct (Dacryostenosis)

What is a blocked tear duct?

A blocked tear duct (nasolacrimal duct obstruction or dacryostenosis) is a common condition in babies. It occurs when the normal drainage system for tears (the lacrimal system) fails to open or becomes blocked (obstructed), stopping the flow of tears from the eyes into the nose.

Who is affected by blocked tear ducts?

Blocked tear ducts are very common in newborns. Up to 70% of all newborns are believed to have blocked tear ducts. They cause noticeable symptoms in 6% to 20% of these babies.

What causes a blocked tear duct?

In babies, the most common cause of a blocked tear duct is blockage of the lower end of the drainage system for tears.

What are the symptoms of a blocked tear duct?

  • Babies who have blocked tear ducts usually have symptoms the first few days to the first few weeks after birth. Symptoms often affect only one eye but may affect both eyes and usually include:
    • Excessive tears, ranging from the eye appearing wet to tears running down the cheek (epiphora).
    • Buildup of a yellowish-white mucus drainage at the inner corner of the eye.
    • Swelling and redness of the eyelids and irritation of the surrounding skin.

    If a tear duct (lacrimal duct) remains partially or completely blocked, the tear duct sac fills with fluid, and an infection can develop. The infection may cause inflammation (redness) and swelling. Yellow mucus can build up in the corner of the eye, and the eyelids may stick together. In severe cases, infection can spread to the eyelids and the area around the eye. The symptoms of a blocked tear duct may get worse after an upper respiratory infection (such as a cold or sinus infection). Also, symptoms may be more noticeable after the baby has been exposed to wind and cold, because these may cause increased production of tears.

    What exams and tests help diagnose blocked tear ducts?

    A blocked tear duct is diagnosed based on a medical history, and a physical through the tear ducts into the nose.

    How is a blocked tear duct treated?

    Usually no treatment is needed for a blocked tear duct in a baby. It usually clears up on its own by the time the baby is 1 year old. Keeping the baby's eyes clean to prevent infection until the duct opens may be all that you need to do. The primary treatment is gentle cleansing of the lids with a warm, clean, wet washcloth. Use a clean portion of the washcloth with each pass. This may be accompanied by a regimen of gentle nasolacrimal duct massage, usually 2 or 3 times a day. With a clean finger, simply rub the area between the inside corner of the eye and the bridge of the nose, working your way down towards the outer nostril (see diagram).

    If signs of infection develop, the baby may need antibiotic eye drops. If the duct remains blocked after the baby is 6 months to 1 year old, a consultation with a pediatric ophthalmologist will be suggested and simple procedure (probing) may be done to open the duct. Other surgical treatment is usually not needed.

    CALL OUR OFFICE

    IMMEDIATELY:

    • Fever is over 100.4 F rectally in an infant
    • If the infection appears to be spreading to the surrounding tissue
    • Your child starts acting very sick.

    During regular hours if:

    • You have other concerns or questions

    This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.


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