Blocked tear duct

What is a blocked tear duct?

Tears protect the eye's surface, then enter tiny openings near the inner corners of the eyelids. Small channels carry them into a tear sac beside the nose and a duct drains them into the nose. A partial or complete blockage can make tears pool or spill down the cheek.

[1]

How tears drain

Open drainage: tears flow towards the nose

Blocked drainage: tears can overflow

Original simplified diagrams. A blockage can occur at different points along the drainage pathway.

What might I notice?

Watering that happens even when you are not crying.
Sticky discharge, crusted lashes or eyelids that stick together.
Repeated irritation or infections; symptoms may affect one eye or both.

[5]

Watering does not always mean a blocked duct. Irritation, dry eye or eyelid problems can also cause it, so persistent symptoms need an eye examination.

[7]

Why does it happen?

In babies, the drainage system may not be fully open at birth, often because a thin membrane remains at the lower end of the duct. In adults, narrowing with age, inflammation, nasal disease, injury or scarring may affect drainage. Occasionally a growth causes a blockage.

[2]

How is it diagnosed?

The clinician asks when symptoms started and examines the eyes, eyelids and drainage openings. Tests may include flushing the drainage passages. Imaging is needed in selected cases, rather than for everyone. The examination also checks for other causes of watering.

[3]

Blocked tear ducts in babies

Many babies improve as the drainage system develops during the first year. An uncomplicated watery or sticky eye can often be monitored with advice from a clinician. If symptoms persist around or beyond the first birthday, or are troublesome earlier, ask about specialist assessment.

[6]

An ophthalmologist may recommend tear-sac massage and should show you the correct technique. Antibiotic drops or ointment may be prescribed for significant discharge, but they do not open the duct. Avoid repeated or prolonged courses without review.

[5][4]

What treatments are available?

Treatment depends on the location and cause of the blockage, age and severity of symptoms. Infection needs treatment too. A procedure is not necessary for every watery eye.

[4]

Observation and care

Often appropriate for babies whose symptoms are mild, with cleaning and any massage advised by their clinician.

[6]

Probing and irrigation

A clinician uses a fine instrument and fluid to open or assess the drainage pathway. This may be considered when a child's blockage persists or for selected adult obstructions.

[4]

Balloon or small drainage tube

Some blockages need widening with a balloon or a temporary silicone tube to keep the passage open. The specialist decides whether this is suitable.

[4]

Drainage bypass surgery (DCR)

For some adult blockages, surgery connects the tear sac directly to the nose, bypassing the blocked duct. It may be performed through a small skin incision or from inside the nose.

[7]

Care at home and follow-up

Wash your hands before cleaning the eye. Gently remove crusts using clean material and the method your clinic recommends. Use only prescribed treatment and do not try to probe the duct yourself. Attend follow-up if watering continues. After a procedure, follow the specific wound, nose-care and medicine instructions you receive.

[8][7]

When to seek urgent help

A tender, red swelling beside the inner corner of the eye, particularly with fever or feeling unwell, can indicate a tear-sac infection (dacryocystitis). Seek urgent medical assessment immediately. Severe eye pain, reduced vision or rapidly increasing redness or swelling also need urgent care.

[5][8]

A baby with a painful or very red eye, unusual light sensitivity or a cloudy-looking eye needs prompt assessment; these are not typical features of a simple blocked duct. Breathing difficulty in a baby with swelling near the tear sac is an emergency.

[9][5]

When to seek urgent eye care