If a tear duct becomes blocked, tears build up and irritate the eyes. This irritation causes painful swelling, makes the eyes appear continuously watery, and increases the risk of infection.
When the tear ducts are functioning correctly, tears roll down from the lacrimal glands — which sit above the outer side of each eye — and across the surface of the eye. They then drain through holes in the eyelids (puncta) into canals, which transport them to a sac (lacrimal sac) on the side of the nose. From there, they move into a duct that empties them into the nose. This duct is the tear duct, or nasolacrimal duct.
This small yet complex drainage system can become blocked at any point. However, the tear duct is the most common site for blockages.
A blockage will prevent tears from making their way out of the eyes and either evaporating or getting reabsorbed.
Keep reading to learn more about the causes, symptoms, and treatment of a blocked tear duct in adults.
Instances of a blocked tear duct in babies are fairly common, and they are usually due to birth abnormalities. Experts estimate that 20% of babies have a blocked tear duct at birth.
Adults most frequently develop a blocked tear duct as a result of:
- an infection in or near the eye
- an injury in or near the eye
- swelling around the eye
- a tumor
For older adults, the abnormal narrowing of the tear drainage system is a common cause of a blocked tear duct.
However, there are many other possible causes of a blocked tear duct. They include:
- chronic sinus infections, which can damage and block nasal tissue over time
- scar tissue from an injury, such as a broken nose
- age-related narrowing of the puncta, which are holes in the eyelids through which tears drain
- nasal polyps
- conjunctivitis and viral infections
- craniofacial abnormalities, such as a deviated septum
Females are twice as likely as males to develop blocked tear ducts, possibly due to their eye drainage canals being narrower.
The following symptoms could indicate a blocked tear duct:
- tears overflowing onto the cheek
- watery eyes
- irritated eyes
- mucus discharge from the eye
- dried discharge forming a crust on the eye
- frequent eye infections
- blurry vision
- swelling on one side of the nose, near the eyes
- bloody tears
When a tear duct becomes blocked, certain factors can make the symptoms worse. These include:
- cold weather
- strong sunlight
- the common cold
- sinus infections
Most children who are born with a blocked tear duct get better without any treatment within 4–6 months.
However, in adults, some form of treatment is usually necessary. The best way to address the problem will depend on the extent and cause of the obstruction. Some common treatment methods include:
In mild cases, the following basic treatment methods are an option:
- cleaning of the eyelids
- warm compresses
- prescription creams to reduce swelling
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If these methods do not work, a doctor can provide some stronger treatment methods.
In more severe cases, doctors will use a surgical procedure called dacryocystorhinostomy. This surgery involves creating a new passage between the lacrimal sac and the nose to bypass the blockage.
The surgeon will place stents in the new passage to keep it open for 3–4 months while it heals. This procedure has a 90% success rate.
In some cases, surgeons may opt to build a new tear drainage system using a procedure called conjunctivodacryocystorhinostomy.
For blockages due to a tumor
If the cause of a blocked tear duct is a tumor, a doctor will recommend first removing or shrinking the tumor through surgery or other treatments.
For blocked or narrowing puncta
Dilation, probing, and irrigation are possible ways to widen the holes and make sure that the passage is open.
For blockages due to chronic inflammation or scars
Balloon catheter dilation, which takes place under general anesthesia, uses a balloon to open closed or narrowed passages.
Significant discomfort, impaired vision, and an increased risk of infection can all result from a blocked tear duct.
Adults experiencing the symptoms of a blocked tear duct should consider seeing a doctor if:
- watery eyes are interfering with everyday activities
- the eye or eyes seem to be watery all of the time
- they have frequent eye infections
- the eye or eyes are consistently leaking or irritated
- they notice traces of blood in their tears
- they have a fever
Several different factors can increase the risk of an adult developing a blockage in the tear drainage system. These factors include:
- Sex: Females are more likely than males to develop a blocked tear duct
- Tobacco use: Smoking increases the risk of this condition.
- Chlorinated water: People who regularly swim in chlorinated water may be more likely to develop problems with their tear drainage systems
In addition, blocked tear ducts are more common in people who have the following conditions:
- Sinusitis: Frequent sinus infections can lead to inflammation and scarring, which increase the risk of blockages.
- Nasal allergies: As with sinus problems, nasal allergies cause swelling, which may lead to scarring and result in blocked tear ducts.
- Craniofacial abnormalities: People with Down syndrome and those with narrow, bony nasal canals or a deviated septum may be more susceptible to blockages in the tear drainage system.
The term “blocked tear duct” is actually a bit of a misnomer because a blockage can affect any of the holes, canals, sacs, and passages that make up the tear drainage system.
However, the tear duct is the most common site for blockages.
When the drainage system becomes blocked, this can cause pain, interfere with vision, and increase the risk of infection.
The symptoms of a blocked tear duct can be bothersome, but effective treatments are available to remove the blockage.