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Lacrimal Duct Stenosis

(Blocked Tear Duct; Nasolacrimal Duct Obstruction; Lacrimal Duct Obstruction; Dacryostenosis)

Definition

Lacrimal duct stenosis involves narrowing of a tear duct (lacrimal duct). This condition can occur in children and adults. This fact sheet will focus on lacrimal duct stenosis in children (babies).
Lacrimal Duct
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The lacrimal duct (in blue) drains tears from the eye down into the nose. The opening of the ducts are near the inner corner of the eye.Copyright © Nucleus Medical Media, Inc.

Causes

In some babies, problems in normal development can cause lacrimal duct obstruction. A thin membrane may cover the opening of the duct into the nose.

Risk Factors

These factors increase your baby’s chance of developing lacrimal duct stenosis:

Symptoms

If your baby has any of these symptoms, do not assume it is due to lacrimal duct stenosis. These symptoms may be caused by other conditions. Tell your doctor if your baby has any of these:
  • Excessive tearing
  • Recurrent red eye or eye irritation
  • Tear duct infection ( dacryocystitis ) causing redness, warmth, swelling around the eye, and discharge with pus
  • Cloudy or mucous-like discharge from the tear duct
  • Crusting on the eyelid
  • Bloody tears

Diagnosis

The doctor will ask about your baby’s symptoms and medical history. The doctor will do an exam. Your baby may need to see a doctor who specializes in eye conditions in children. The eye doctor may do a dye disappearance test. This test will help to confirm that there is a blockage in the tear duct.

Treatment

Talk with the doctor about the best treatment plan for your baby. In infants, this condition often heals by itself in the first year of life. It may be treated by massaging or opening up the blocked tear duct.
Treatment options include:
  • Massage—The doctor may gently push on the area where the tear duct runs out of the eye, between the baby’s eye and nose. This helps to push tears through the duct.
  • Probing—The doctor may pass a tiny probe into the duct to open it up. In some cases, the ducts may be dilated with a balloon or stented to keep them open.
  • Surgery—In some cases, surgery may be needed to open up the duct. In one type of surgery, the doctor puts a tiny, flexible instrument into the tear duct to see what is causing the blockage. The doctor may then flush fluid through the instrument. A laser may be used to cut away the blockage.

Prevention

It is not possible to prevent this condition. To help reduce your baby’s chance of getting eye infections, keep your baby’s eyes clean and free of mucous.

RESOURCES

American Academy of Pediatrics http://www.aap.org

National Eye Institute http://www.nei.nih.gov

CANADIAN RESOURCES

Canadian Ophthalmology Society http://www.eyesite.ca

Canadian Pediatric Society http://www.cps.ca

References

DynaMed Editors. Nasolacrimal duct obstruction. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated April 8, 2010. Accessed April 20, 2010.

Hurwitz JJ. The lacrimal drainage system. Ophthalmology . 2nd ed. St. Louis, MO: Mosby; 2004: 761-768.

Kids Health. Causes of blocked tear ducts. Kids Health website. Available at: http://kidshealth.org/parent/general/eyes/tear%5Fduct%5Fobstruct%5Fsurgery.html# . Accessed April 22, 2010.

Mayo Clinic. Blocked tear duct: risk factors. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/blocked-tear-duct/DS01096/DSECTION=risk-factors . Updated October 2008. Accessed April 22, 2010.

Merck Manuals. Tearing. Merck Manuals Online Medical Library website. Available at: www.merck.com/mmpe/print/sec09/ch098/ch098k.html . Updated April 2009. Accessed April 20, 2010.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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