What should I know about the probing procedure for opening a blocked tear duct?
The probing procedure to open a blocked tear
duct is usually not done in a baby younger than 6 months of age.
Probing may be done in a doctor's office using
local anesthesia if your baby is younger than 1 month
of age. For older babies, it is usually done in a surgical center or hospital
general anesthesia. A doctor may use his or her
judgment about the need for anesthesia based on the child's age, weight, and
It may take several days for babies to heal after
probing has been done.
Sometimes a probing procedure has to be
repeated. Six weeks after surgery, in the doctor's office, the child's tear
duct may be checked with a dye solution. If the duct is still blocked, massage
and antibiotics are used for 4 to 6 more weeks. Then, if excessive tearing
continues, the probing procedure is done again.
return for a short time after the probing procedure is done if the child gets
upper respiratory infection, such as a sinus infection
or a cold.
How effective is the probing procedure for blocked tear ducts?
Most blocked tear ducts go away on their own by a baby's
first birthday. If a child's tear duct has not opened by the time he or she is
12 to 13 months old, the probing procedure for blocked tear ducts is usually
done. Probing successfully opens the duct in about 90 out of 100 babies who
have blocked ducts.1
One study of
children with blocked tear ducts showed that the probing procedure worked
- 89 out of 100 children who were probed at age 2.
out of 100 children probed at age 3.
- 71 out of 100 children probed
at age 4.
- 42 out of 100 children probed at age 5.
In most cases, when a young child's blockage is caused
by a simple obstruction, probing works well. A simple obstruction usually
occurs when a thin tissue covering the opening at the end of the tear duct does
not open normally at or near birth. For more complicated types of obstructions,
the probing procedure is successful about half the time.
What are the risks of having a probing procedure to open a blocked tear duct?
Every medical procedure has some risks, such
as infection and bleeding. These risks are also present with a probing
procedure to open blocked tear ducts.
One of the major but rare
risks of a probing procedure is scarring of the
drainage system between the eye and the nose (lacrimal duct). The scarring cannot
be seen on the baby's face. But scarring may lead to further blockage, making
it harder to open the tear duct during a repeat probing.
also risks associated with anesthesia.
- Children usually need general anesthesia to
keep them perfectly still during the procedure, but general anesthesia has
greater risks than local anesthesia.
- Local anesthesia has few or no
risks, but the pain control is not as good. Also, babies need to be restrained
to keep them very still during the procedure. Local anesthesia is not
recommended for babies 1 month of age or older.
What are the risks of delaying or not having a probing procedure to open a blocked tear duct?
The risks of delaying or not having
a probing procedure to open a blocked tear duct are minimal in young
- In very rare cases, a baby may develop
serious infections of the areas surrounding the eye, including infection of the
lining around the eye (pinkeye, or
conjunctivitis), the skin around the eye (cellulitis),
or the tear duct sac located inside and below the lower lid (dacryocystocele).
These infections occur because tears well up behind the blockage and provide a
place for bacteria to grow.
- Repeated infections from blocked tear
ducts may result in scarring of the tear duct (lacrimal duct). This
complication is rare and is usually corrected by probing.
Another risk of delaying probing is that babies 1 month
of age and older usually need general anesthesia to ensure that they remain
very still during the procedure.
A child's vision is not impaired
by a blocked tear duct, so delaying or not having the procedure to open a
blocked tear duct will not change your child's ability to see.
If you need more information, see the topic
Blocked Tear Ducts.