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How to Fix a Blocked Tear Duct (Causes & Treatments)

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Sometimes, blocked tear ducts can be treated by simply massaging the face around the lacrimal sacs, administering eye drops, or taking antibiotics.

If those methods don’t work, a doctor will try dilating or intubating the tear ducts. Finally, there is surgery.

How to Fix a Blocked Tear Duct

In some cases, a blocked tear duct can be fixed with a do-it-yourself approach. If the situation does not improve, and the eyes keep tearing over for a period of days, you should alert your doctor, as this could be the result of a serious issue that needs immediate attention (like a tumor).

Usually, the best course of treatment for a blocked tear duct varies according to the reason for the blockage.

If an infection is the likely culprit, for example, antibiotic eyedrops or pills will be a doctor’s choice.

If a baby is born with a blocked tear duct, the usual strategy is to simply wait it out because the drainage system should develop within the first couple months of the baby’s life. In the event that the blocked tear duct doesn’t open up, the pediatrician may teach the parents how they can carefully massage around the face and eyes (specifically, the lacrimal sac, where tears drain from the eye into the tear duct) to encourage the ducts to open up.

A patient who has sustained a facial injury that has blocked their tear ducts will likely be advised to wait a few months to see if the blockage resolves as the face heals. As swelling reduces, it is likely that the tear ducts will be allowed to function again.

Dilation & Intubation

Sometimes, these home remedies and waiting it out don’t work, and the tear ducts remain blocked. If this continues to be a problem, or if it appears that the blockage is more serious than initially thought (and cannot be remedied by antibiotics, for example), the next option will usually be surgery or another form of more involved treatment.

Babies, for instance, might be put under general anesthesia, so the doctor can enlarge the tear ducts with a dilation instrument. They will then insert a thin probe into the drainage system to remove the blockage. For adults, instead of using a probe, the doctor will likely flush the tear duct. This can be done in an outpatient setting.

Another option is balloon catheter dilation, where the patient is put under anesthesia. The doctor then threads a tube through nose, with a deflated balloon at one end of the tube. They inflate and deflate the balloon a few times until the blockage is opened.

Stenting or intubation is another method of opening up the tear ducts, where a thin tube is threaded through an opening in the corner of the eyelid and inserted through the tear drainage system in the nose. The tube is left in place for about three months. Then, it’s removed after it has propped the ducts open long enough that they can function on their own.

Surgery (Dacryocystorhinostomy)

If none of these methods are successful in unclogging the tear ducts, the only remaining option is surgery. The form of surgery that is most commonly used is called dacryocystorhinostomy. It opens up the passageways for tears to be properly drained from the nose.

Depending on the extent and location of the blockage, the dacryocystorhinostomy can be done with local or general anesthesia. There are two main types of this surgery.

EXTERNAL DACRYOCYSTORHINOSTOMY

THIS IS WHEN A SURGEON MAKES AN OPENING ON THE SIDE OF THE NOSE, CLOSE TO THE LACRIMAL SAC, TO CONNECT IT TO THE NASAL CAVITY. THEN, THEY PLACE A STENT IN THE NEW CONNECTION AND CLOSE UP THE SKIN INCISION.


ENDOSCOPIC DACRYOCYSTORHINOSTOMY

THIS IS WHEN MICROSCOPIC INSTRUMENTS ARE INSERTED INTO THE DUCTS THROUGH THE NOSE. THIS METHOD DOES NOT REQUIRE ANY INCISION, SO THERE IS NO SCARRING ON THE FACE. ENDOSCOPIC DACRYOCYSTORHINOSTOMIES ARE CONTROVERSIAL. THEY ARE MEANT TO BE LESS INVASIVE THAN EXTERNAL DACRYOCYSTORHINOSTOMIES, BUT THIS MEANS THEY MAY NOT BE AS EFFECTIVE.


Notwithstanding the debate, the Allergy & Rhinology journal concludes that an endoscopic dacryocystorhinostomy is an “effective procedure” for adult patients, so it is one way to fix a blocked tear duct when all other methods have failed.

Why Do Tear Ducts Get Blocked?

There are a number of reasons why a tear duct can become blocked. In some cases, the blockage is congenital, meaning the patient is born with the tear duct already blocked. This might be because their tear drainage system does not properly develop when they are in the womb. Alternatively, there might be a problem with the development of the tear duct itself.

Some problems with the tear ducts emerge as the person gets older. The small openings that supply and drain the tears can get narrower as time goes on, causing tear formation to become blocked. If the person has an injury to the face, any resultant bone damage can change the normal flow of tears through the duct system. Loose skin cells or dirt that get lodged in the tear duct can block tears.

Tumors in the nose can block the tear ducts, as can sarcoidosis or granulomatosis, inflammatory conditions that can cause swelling and prevent the tear ducts from functioning normally. Cancer treatments like chemotherapy can also cause a blocked tear duct as a side effect.

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