Having a blocked tear duct means your tears can’t drain normally out of that eye. The condition is common in infants, but it can develop in adults, too. And while a blocked tear duct is often harmless for babies, in adults it can sometimes be a sign of a serious health problem.
Blocked tear ducts are often treatable and temporary, but if the condition lingers, you should see a doctor.
What are the symptoms?
The most common symptom of a blocked tear duct is watery eyes and tears streaming from the eyes.
Other symptoms of a blocked tear duct can include:
- redness and irritation of the affected eye
- mucus or discharge coming from the eye
- crust forming on the eyelids
- eye infections, such as conjunctivitis, or pink eye
- blurred vision
- pain and swelling of the inside corner of the eye
You may develop watery eyes alongside a cold, sinus infection, or eye infection unrelated to the tear ducts. Exposure to wind or bright sunlight can also trigger excessive tearing.
Swelling around the eye and eye redness may also be the result of an injury to the eye that may or may not affect the tear ducts.
If the blocked tear duct is the result of a bacterial infection, you may also have a fever along with those other symptoms.
What are the causes?
A leading cause of blocked tear ducts in adults is infection of the eyes, tear duct system, or nasal passages. An injury or trauma to the eye can also lead to a blocked tear duct. The trauma could be as minor as getting some dirt or other foreign particles in your eye, or as serious as a blow to the head that injures the eye or eye socket. A broken nose can affect the tear ducts, too.
A tumor, even a noncancerous one, can cause a blocked tear duct if it’s anywhere in or near the tear duct drainage system. Nasal polyps may also be to blame.
If you’re undergoing chemotherapy for cancer treatment, a possible side effect is a blocked tear duct.
How do tears normally flow?
Most of your tears flow from the lacrimal glands. These are above each eye. When you blink, your inner eyelids spread tears across the eyes to keep them lubricated and healthy. The tears then move into holes, called puncta, in the corners of eyes, and then eventually into your nose. The moisture from tears is reabsorbed into your body, or it evaporates.
What are the risk factors?
If you get chronic eye or nasal passage infections, you may experience frequent bouts of blocked tear ducts. Treating or preventing these underlying causes should help reduce the frequency and intensity of blocked tear duct episodes.
As you get older, your risk of a blocked tear duct increases. The puncta that help drain your tears get narrower. This can make your tear ducts more likely to become blocked.
If you have glaucoma or another eye condition that requires eye drops for treatment, you may also be at a higher risk for tear duct problems. Long-term use of medicated eye drops may contribute to blocked tear ducts.
Adults and children with abnormal facial or cranial developments, such as those associated with Down syndrome, are at a higher risk for several conditions, including blocked tear ducts.
Are contact wearers at increased risk for blocked tear ducts?
Wearing contact lenses doesn’t necessarily raise your risk of a blocked tear duct. But wearing dirty lenses can cause an infection and subsequent blockage of one or both tear ducts.
Always wash your hands before removing or putting on contact lenses. Follow your doctor’s recommendations for keeping your lenses clean. It’s also important to keep your storage case clean.
If your eye becomes red or swollen, make an appointment to see your eye doctor.
You should also make a doctor’s appointment if you’re experiencing excessive tears for more than a few days, or if you notice pus or other discharge around your eye.
If you don’t have an ophthalmologist or optometrist — doctors who specialize in eye health — you can make an appointment to see your primary care doctor. If they’re unable to treat you, they can refer you to an eye doctor.
Diagnosing the problem starts with a thorough eye exam. Your doctor may also flush a special fluid into the tear duct opening. If you can’t taste the fluid, that means it hasn’t made it down to your throat. If the fluid doesn’t make it to your throat, your doctor should be able to diagnose a blocked tear duct.
If you experience recurrent blocked tear duct episodes, talk with your doctor. This is true even if the problem tends to resolve on its own. Tell your doctor how often it occurs and other symptoms you experience, if any, when you have tear duct problems.
Treating a blocked tear duct
For adults with a blocked tear duct, treatment usually require a doctor’s attention. There’s no home remedy, though keeping your face and eyes — and contact lenses if you use them — clean may help prevent tear duct complications in the future.
The proper treatment for a blocked tear duct depends on the underlying cause.
If you have a bacterial infection, your doctor will prescribe antibiotic eye drops or pills to treat the infection.
For a narrowed punctum, your doctor can use a small probe to widen it. They’ll then flush or irrigate the tear duct with a saline solution. This is an outpatient procedure.
If an injury caused the blockage, your best approach may be to wait several weeks to see if it heals on its own without any treatment.
Other treatments for a blocked tear duct may include:
Balloon catheter dilation
Your doctor guides a very thin catheter through the blockage in the tear duct, starting from the nose. They then inflate a tiny balloon several times to push away the blockage and open up the duct system. This requires general anesthesia.
Stenting or intubation
Your doctor threads a thin tube through the puncta and throughout the tear drainage system to the nose. The tube, or stent, remains in place and allows tears to drain normally. The procedure also requires general anesthesia.
The surgical procedure is called dacryocystorhinostomy. It can be done through an incision on the side of the nose near the lacrimal sac or with special endoscopic tools through the nasal cavity, which leaves no visible scar.
What’s recovery like?
If surgery is necessary, ice packs should be placed on the affected area for about two days after the operation to help reduce swelling. You’ll probably have to keep your head at a 45-degree angle and avoid blowing your nose for about a week. These precautions are meant to prevent hemorrhage.
Sutures can usually be removed in a week or so, unless absorbable stitches were used during surgery.
Normal activities should be possible after a week, though you should avoid activities that could lead to facial trauma, such as martial arts, soccer, or similar sports.
There should be little or no recovery period for other procedures, aside from basic precautions to keep your eyes and nose injury-free.
What’s the outlook?
With surgery, your outlook is good. There’s about a 90 percent success rate with dacryocystorhinostomy. Other less-invasive treatments may be just as effective. The key is having the cause of your blocked tear duct diagnosed and working with an ophthalmologist who’s experienced in treating this condition.
If you haven’t had a full medical eye exam in a while, schedule one soon, especially if you suspect a blocked tear duct.