Blocked Tear Duct? What to Expect From Treatment

If you have a blocked tear duct, there are ways to get relief. Treatments can widen or bypass a blocked tear duct to help tears drain normally out of your eye again. Opening up the ducts often eases symptoms like tearing, pain, and redness.

Not everyone needs to be treated for a blocked tear duct. For example, with most babies, the blockage will clear up as the child's drainage system matures. Some infants are born with a piece of tissue called a membrane covering the duct, but it usually opens up on its own in the first year of life.

When a blocked tear duct doesn't open on its own, these techniques can help infants and adults:

Massage

One of the easiest ways to fix a blockage in babies (or adults) is to massage the lacrimal sac -- the area where tears drain from the eye into the tear duct.

Twice a day -- in the morning and at night -- take a cotton swab or clean fingers and gently rub the lower corners of your baby's eyes, next to the nose for a few seconds. This motion should cause a clear fluid to drain out of the corners of the eyes. The pressure of the massage can pop open the membrane that covers the tear duct.

Antibiotics

Your doctor may prescribe antibiotic eye drops or ointment. Antibiotics won't open the blockage, but they can treat an infection and clear up any discharge coming from the eye.

Tear Duct Probing

If your child's tear duct doesn't open on its own by age one, the doctor can do a procedure to remove the blockage. While your baby is asleep, the doctor places a thin probe into one or both holes that tears drain through and opens up the tissue that covers the tear duct. This is a pain-free procedure and, most of the time, undoes the blockage.

For a few hours after tear duct probing, some children have blood-colored fluid drain from the eye. Using antibiotic eye drops or ointment a few times a day for about a week can help prevent an infection.

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Balloon Catheter Dilation

If the blockage doesn't get better on its own or with probing, the doctor might try balloon catheter dilation.

While your child is asleep, the doctor threads a thin tube called a catheter into the tear duct. A pump inflates a balloon at the end of the tube. The doctor then deflates and inflates the balloon again to widen the duct. Then he removes the balloon.

Intubation

Intubation may be another option if other treatments don’t work. In this procedure, the doctor threads a tiny tube through the holes, or puncta, in the corners of the eyes. The tube passes through each tear duct to the inside of the nose.

The procedure takes about an hour. The tubes stay in place for three to six months to open up the ducts and let tears drain.

Intubation can cause side effects such as:

  • A stuffy nose (saline drops can help relieve the congestion)
  • More tearing (this should improve by the time the doctor removes the tubes)
  • Movement of the tube (your doctor will put it back in place)

Surgery

A type of surgery called “DCR” (dacryocystorhinostomy) bypasses the blocked tear duct. Doctors usually do it in adults who haven't improved with other treatments. They rarely use it in children.

DCR creates a new route for tears to drain from the eye. Sometimes the new opening totally bypasses the tear drainage system and lets tears flow straight into the nose.

Doctors can do DCR while you are asleep or awake. The surgery can be done in one of two ways:

  1. External. The surgeon makes a small cut on the side of your nose, which they close with stitches.
  2. Endoscopic. The surgeon inserts tiny instruments and a camera through the opening of your nose. This type of surgery causes less pain than external surgery and it doesn't leave scars.

The surgeon will place a tube inside the new opening while it heals. The doctor will remove the tube in about three or four months.

DCR usually relieves the tear duct blockage and its symptoms. Possible side effects include:

  • Infection (your doctor will give you antibiotics to prevent this)
  • Scars (from external surgery)
  • Stuffy nose (you can treat this with a decongestant nasal spray)
  • Bruises

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Discuss all your treatment options with your doctor. Ask questions so you understand how the procedure will help and what side effects it might cause.

WebMD Medical Reference Reviewed by Alan Kozarsky, MD on August 09, 2018

Sources

SOURCES:

American Academy of Ophthalmology: "Blocked Tear Duct."

American Association for Pediatric Ophthalmology and Strabismus: "Nasolacrimal Duct Obstruction."

American Rhinologic Society: "Dacryocystorhinostomy (DCR)."

Pediatric Eye Disease Investigator Group. Archives of Ophthalmology, 2009.

Seattle Children's Hospital: "Tear Duct, Blocked."

UW Health: "Blocked Tear Ducts in Children," "Frequently Asked Questions: Blocked Tear Duct and Silicone Intubation."

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