Most babies born with a blocked tear duct will not need surgery. But when surgery is necessary, a simple probing procedure is used, most of the time. Probing involves passing a thin wire through the blocked tear duct to open it.

Probing is usually done in the doctor's office under a local anesthetic (numbing eyedrops) for babies younger than 1 year of age. General anesthesia, which is usually done in an outpatient hospital setting, can be used for older babies. The doctor is able to evaluate your baby's tear duct more thoroughly if general anesthesia is used. Also, if needed, an additional procedure to resolve the blockage often can be performed at the same time and prevent the need for another surgery later.

For adults, treatment for a blocked tear duct depends on its cause. Probing is typically not effective in adults, and other surgical procedures are usually used.

Other types of surgery for a blocked tear duct in babies or adults may include breaking a nasal bone, placing a tube in the tear duct, or surgically creating a new tear duct.

Surgery Choices

Surgical options for a blocked tear duct include:

• Probing, which involves passing a thin wire through the blocked tear duct to open it. Probing has been shown to successfully open the tear duct in 97% of babies who are 13 months of age or younger.³

  Should my baby have a probing procedure to open a blocked tear duct?

• Intubation, which involves placing a silicone tube through the tear duct to maintain a passageway for tears to drain into the nostril. This may be done if the duct has excessive scarring or if it is difficult to pass the probe through the duct. Intubation may also be needed if probing is being repeated because a previous probing failed to open the tear duct.
• Infracturing, in which a nasal bone deep within the nose is broken to create an open duct and improve a passageway into the nostril. Infracturing will not permanently affect the size or shape of a baby's nose.
• Balloon dacryocystoplasty, in which a tiny balloon at the end of a probe is used to open the tear duct.

Surgical options that are rarely used for children-and only after the above procedures have failed-include:

• Dacryocystorhinostomy, which creates a new tear duct canal.
• Endoscopic and laser dacryocystorhinostomy. This procedure creates a new tear duct by using a lighted instrument and passing a flexible tube with a tiny camera on the end (endoscope) into the nostril.

In adults, treatment for a blocked tear duct depends on the cause of the blockage and can include any of the above choices.

What To Think About

About 6 weeks after a surgical treatment, you or your child will usually visit the doctor for an eye exam and may be tested again with the fluorescein dye disappearance test.