Blocked tear duct

• Alternative Names

  Dacryostenosis; Blocked nasolacrimal duct

• Causes, incidence, and risk factors

  A tube called the nasolacrimal duct normally drains tears from the surface of the eye into the nose. If this duct is blocked, the tears will build up and overflow onto the cheek, even when a person isn't crying.

  In children, the duct may not be completely developed at birth. In adults, the duct can be damaged by infection, injury, or a tumor.

• Symptoms

  The symptom is increased tearing, which overflows onto the face or cheek.

• Signs and tests
  • Examination of the inside of the nose
  • Fluorescein eye stain to see how tears drain
  • Special x-ray studies may be done to examine the duct
  • Standard ophthalmic exam
• Treatment

  In children whose nasolacrimal duct has not developed fully, massaging the area several times a day may be enough to open the tear duct. Cases that do not improve may need to be opened by a probing procedure. This may require anesthesia.

  In adults, the cause of the blockage must be treated. This may re-open the duct if there is not much damage. Surgery to reconstruct the passageway may be needed to re-establish normal tear drainage, and stop the overflow onto the cheek.

• Expectations (prognosis)

  Tear duct blockage that is present at birth (congenital) often clears up by itself by the time the child is 6 months old. If it does not clear on its own, the outcome is still likely to be good with treatment.

  The outlook for a blocked tear duct in adults varies depending on the cause.

• Complications

  Tear duct blockage may increase the risk of eye infections.

• Calling your health care provider

  See your health care provider if you have tear overflow onto the cheek, because a tumor is one of the possible causes. Earlier treatment is more successful, and may be life-saving.

• Prevention

  Many cases cannot be prevented. Properly treating nasal infections and conjunctivitis may reduce the risk. Safety measures may reduce the risk of trauma that can cause a blockage.

Review Date: 8/1/2008

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.