Tear Duct Obstruction is a common condition in infants and young children. Approximately one-third of all infants are born with tear duct obstruction, causing exessive tears and mucus.
Tears drain from the eyes through two small openings called the upper and lower punctum which are located along the upper and lower eyelids near the nose. The tears then flow through the canaliculus into the lacrimal sac located under the skin on the side of the nose.
From the sac, the tears are pumped by the blinking action of the lids into the tear duct. These ducts go through the bones of the nose and empty the tears into the back of the nose.
Overflow tearing is usually caused by the presence of a persistent membrane that blocks the lower end of the tear duct inside the nose. Normally this membrane opens at or before birth. In many infants, however, it is still closed at birth clogging the tear drainage system. The blockage may open spontaneously as the infant grows.
Initially, antibiotic eye drops or ointments may be used along with pressure (or massage) over the tear sac, to control the discharge and try to open the blockage. If the tearing persists, it may be necessary for the eye specialist to open the tear ducts by probing and irrigation.
A thin, blunt metal wire is gently passed through the tear drainage system to open any obstruction. Infants experience no pain after the probing but some blood-staining of the tears or nasal secretion is common and a discharge from the eye may be present for up to a week. Antibiotics may be prescribed. In the rare case of a recurrent obstruction a repeated probing may be required.
If probings are not successful, plastic or silicone tubes can be placed in the drainage canals. Very rarely , further surgery is needed to bypass the blocked tear duct and create a new opening through the bone into the nose.
As with any surgical procedure, there is the possibility of infection or bleeding. Scarring can re-obstruct the opening, requiring additional surgery. Chronic obstruction can lead to infections of the tear sac at any age.