A blocked tear duct prevents tears from exiting the eye properly. Tear ducts are the draining system for tears and can sometimes fail to open due to inflammation or infection. A blockage can cause watery, irritated eyes that become red and uncomfortable. It is typically easily treated and will often clear up on its own with no treatment, especially in children. Recurrent or severe blockages can sometimes lead to more invasive procedures and even surgery.
The most common symptoms of a blocked tear duct are excessive watery eyes, redness to the corner of the eye, and crust developing on the eyelids. Swelling can also develop that is painful. Some patients also suffer from blurred vision and discharge coming from the affected eye. The condition can also cause other eye infections like conjunctivitis to occur.
Newborn babies are the most common age group associated with this problem. The main reasons are debris from being in the womb or a congenital disability where the duct hasn't yet fully developed. When adults develop the problem, it is typically due to an injury or another illness such as a sinus infection. Another factor can be age. As we get older, tear ducts get smaller and can become blocked more easily. People with chronic eye infections are also more at risk of developing the problem.
Not all cases are preventable, but some things can be done to help prevent a blocked tear duct. Keeping anything that comes in contact with your eyes clean is a must. Make-up like eyeliner and mascara should be replaced regularly and never shared. Hand washing often and keeping fingers out of the eye can also drastically reduce the chances of a blocked tear duct as well as other eye problems.
There are several diagnostic tests available to help determine if there is a blockage and the severity. A doctor may use a saline solution to irrigate the tear duct and see how well it is draining. A tiny probe can be inserted into the duct as well to see if there is a blockage and sometimes will even dislodge the blockage. There is also a dye that can be placed in the eye. Depending on how fast the dye drains can determine if there is a blockage. More in-depth testing such as CT scans and MRI's can be done in severe cases.
A tear is a tear is a tear right? Wrong! There are actually three different types of tears that exist in the eye. They not only serve different purposes but are made of different substances as well. There are the tears that we are most familiar with, emotional tears. These tears often appear out of our control when we are extremely happy or sad. They are filled with stress hormones that actually provide physical relief from pain! Basal tears are the tears that are always present in our eyes. They keep the eyes wet and protected. Reflex tears happen when the eye is exposed to an irritant like wind or dust. They have antibodies and keep our eyes healthy.
Whenever we blink a tear is spread over our eyes to help protect them and keep them moist. This is called a tear film, and it is actually made up of three different layers to help prevent damage and dryness. There is an oil layer that helps prevent evaporation, a water layer that lubricated and washes away debris, and a mucin layer. The mucin layer nourishes the cornea and also helps tears stick to the eyes surface.
Most cases of a blocked tear duct are mild and don't require a trip to the doctor's office. Some things can be done at home to ease symptoms and clear up the problem. A gentle massage with a cotton swab can be done twice daily to open the duct. A warm compress can be held to the eye before the massage and might also make the eye feel better. Cleaning the eye with cold water a couple of times a day might also help.
If you have a blocked tear duct that is not clearing up with home treatment or time, a trip to the doctor may be necessary. If an infection is the source of the problem, there are antibiotic eye drops that can be prescribed. The eye may be flushed and massaged in the office to promote healing.
Some blocked tear ducts don't respond to conventional treatments and may require procedures to fix. These procedures have to be done under general anesthesia but are very successful. Stenting or intubation of the eye is when a small plastic tube is inserted into the tear duct system. The tubes stay in for up to three months keeping the duct open and functioning. There is also a procedure called balloon catheter dilation where a small balloon is inserted into the duct and inflated several times. The purpose is to remove the blockage.
If all else fails, there are surgical procedures that can be done to fix a blocked tear duct. The operation is called dacryocystorhinostomy, a name bigger than the eye itself. There are two options depending on where the blockage is and how severe it is. One requires an incision and placement of a stent and one uses microscopic instruments and cameras to open the blockage. The stent is removed after six months. During this time the patient is often put on nasal decongestants and eyedrops to prevent infections.
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