What Is a Blocked Tear Duct?

Tear duct blockage refers to narrowing or obstruction of the passages that drain tears into the nose. Symptoms may include watering, crusting on the eyelashes and swelling at the inner corner of the eye near the nose. The problem may extend beyond the visible inner corner; different parts of the tear drainage system can be affected.

Not every watery eye has a blocked duct. Dryness, allergy, eyelid problems and ocular surface irritation can also cause watering. Drops or massage cannot be considered suitable for everyone before examination identifies the site and cause of any obstruction.

After spreading over the ocular surface, tears collect through small openings near the nose in the upper and lower lids. They pass through fine channels to the tear sac and then towards the nose. Reduced drainage can cause tears to overflow onto the cheek.

The inner corner of the eye, tear sac and tear duct are different structures. The everyday phrase “blocked inner corner” does not identify the exact site of obstruction. The level of the drainage problem is one factor that determines treatment.

Persistent or intermittent watering, crusting, sticky eyelashes in the morning and recurrent discharge may occur in one or both eyes. Watering may become more noticeable in wind, cold weather or with a blocked nose.

The development of painful redness and swelling in the inner corner of the eye suggests a possibility of infection in the tear sac. If accompanied by fever or a general feeling of unwellness, evaluation should not be delayed. Attempting to drain the swelling by pressing it is not appropriate.

In babies, a common cause is a thin membrane that has not opened at the end of the duct where it enters the nose. Watering and discharge may be present from early life. In many babies, the duct may open within the first year; follow-up is planned according to symptoms and examination findings.

When watering is accompanied by marked light sensitivity, corneal clouding or an enlarged eye, a blocked duct should not be assumed to be the only possible cause. Other conditions, such as congenital glaucoma, need to be ruled out. The cause of a baby’s eye symptoms cannot be determined from appearance alone.

In adults, assessment may consider narrowing of the tear drainage pathways, previous infections, injuries or problems involving the nose and the area around the eye. Eyelid position and its role in collecting tears also matter. Tell the doctor how long the watering has been present and whether you have had previous surgery.

The expectation of spontaneous opening in babies does not directly apply to adults. Persistent watering on one side, recurring tear sac swelling or blood-stained discharge requires detailed assessment. Suppressing symptoms with drops alone may not resolve the underlying drainage problem.

The examination assesses the ocular surface, eyelids, tear drainage openings and area near the nose. Vision and accompanying diseases also need assessment. Depending on age and symptoms, a dye disappearance test or tear drainage irrigation may be used.

It is not necessary to use the same tests in every patient. It is attempted to determine whether the excessive tear production is due to excessive tear production, or whether the outflow of tears is impaired. In necessary cases, the structures inside the nose are also evaluated.

Tear sac massage may be recommended for suitable babies. A doctor should demonstrate the location and technique to the family. Painful red swelling or fever requires assessment rather than continuing massage at home.

Antibiotic eye drops are used for discharge and infection when necessary; they do not directly clear a blocked channel. Therefore, continuous use of drops should not be considered a permanent solution. It should not be assumed that massage will clear a blockage in adults.

When evaluating blockages in infants during follow-up, if the blockage does not resolve or causes significant distress, probing may be considered. In some cases, silicone tubes or other interventions may be necessary. The duration of the procedure is determined not only according to the patient’s chronological age, but also in conjunction with the symptoms and the condition of the eye.

Different procedures may be used in adults according to the level of blockage. These include operations creating a new passage between the tear sac and the nose. Detailed information is available in tear duct obstruction treatment page provides this information.