Congenital Nasolacrimal Duct Blockage

What is a blocked nasolacrimal duct?

The tears that keep your eye moist drain away through a tiny opening in the corner of the eye. From there the fluid passes into the nose, where the body absorbs and disposes of it.

A blocked tear duct is a full or partial obstruction of the passageways that drain tears into the nose. If a tear duct is blocked, the eyes may become itchy, irritated and watery.

How does the tear system work?

In normal circumstances, the tear system keeps the eyes comfortably moist without letting them become watery.

The tear system has three parts:

• Lacrimal glands produce the tears.
• Puncta are the small openings at the corner of the eye through which tears drain.
• Nasolacrimal ducts connect to the puncta and carry the tear fluid down into the nose.

What are the symptoms of a blocked tear duct in infants?

Babies do not start producing tears until they are a few weeks old, so a blocked tear duct may not be obvious in a newborn straight away. As a baby grows, the signs of a blocked tear duct may include:

• Redness around the eye, usually caused by the baby rubbing it.
• Tears running down the baby’s cheek instead of draining from the corner of the eye.
• Tears pooling near the corner of the eye but not draining.
• A yellowish discharge or mucus in the baby’s eye

What is the treatment for a blocked tear duct in babies?

A blocked tear duct in a newborn often resolves without any treatment: during the first few months of life, the tear ducts may simply mature and clear the blockage on their own.

Sometimes a small piece of tissue inside the nose continues to block the flow of tears. In this case, your baby’s doctor may teach you a special tear-duct massage technique that helps open the tissue so the tears can drain as they should.

If a watch-and-wait approach does not succeed, doctors may use dilation and flushing, balloon catheters or stents. These treatments work in babies just as they do in adults; however, general anaesthesia is used to keep babies still and calm during the procedure.