What is a blocked tear duct?

Tears normally drain from the eye through small tubes called tear ducts that stretch from the eye into the nose. A blocked tear duct occurs when the opening of the duct that normally allows tears to drain from the eyes is obstructed or fails to open properly. If a tear duct remains blocked, the tear duct sac fills with fluid and may become swollen and inflamed, and sometimes infected.

Blocked tear ducts occur in about 6 out of 100 newborns.¹ A blocked tear duct that is present at birth (congenital) is called nasolacrimal duct obstruction.

Blocked tear ducts are uncommon in adulthood. They mostly occur in older adults and are usually the result of aging or an injury.

What causes a blocked tear duct?

In babies, the most common cause of a blocked tear duct is the failure of the thin tissue at the end of the tear duct to open normally.

Other less common causes of blocked tear ducts in children include:

• Infections.
• Abnormal growth of the nasal bone that puts pressure on a tear duct and closes it off.
• Closed or undeveloped openings in the corners of the eyes (puncta) where tears drain into the tear ducts.

In adults, tear ducts may become blocked as a result of a thickening of the tear duct lining, nasal or sinus problems, injuries to the bone and tissues around the eyes (such as the cheekbones), infections, or abnormal growths such as tumors.

What are the symptoms?

Usually, the first symptom of a blocked tear duct is excessive tearing, ranging from a wet appearance of the eye to tears running down the cheek. Babies who have blocked tear ducts usually have symptoms within the first few days to the first few weeks after birth. If infection occurs in the eye's drainage system, you may see redness and swelling (inflammation) around the eye or nose. Also, 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 exposure to wind, cold, and sunlight.

How is a blocked tear duct diagnosed?

A blocked tear duct is diagnosed based on a medical history and a physical exam. Also, tests may be used to measure the amount of tears or to see whether tears are draining normally from the eyes. Other tests can help your doctor find out where the blockage is or how it was caused.

How is it treated?