Identifying and Treating a Blocked Tear Duct

Introduction

The eyes are the organ of vision. During travel through dust roads, eyes often get irritated by dust particles, and tears drop off by cleansing them. Tears are believed to protect eyes from irritating agents like dust and dirt. Tears are good at maintaining healthy eyes by preventing dry eyes. Tears carry out significant functions, and if the tear duct is blocked for it to drain naturally, functions are all affected. Blocked tear ducts result in irritant and watery eyes. The cause could be an infection or an injury. This article will explain the causes, effects, and management of blocked tear ducts.

What Are the Causes of Blocked Tear Ducts?

The factors causing a block in the tear duct includes,

• Age: As a person gets older, the opening of the duct gets narrower and gets blocked eventually.

• Injury: Injury to the face causing damage to the bone or scarring near the tear duct can block the tear duct. Dirt or cells of the skin, however tiny, can also block the tear duct.

• Eye Drops: Using eye drops for a long time for conditions like glaucoma or cataract can cause tear duct blockage.

• Infection: Any severe infection to the eyes, nose, or tear drainage system can cause blockage.

• Tumor: The presence of a tumor anywhere near the tear duct can cause blockage.

• Cancer Treatments: Blocked tear duct is a side effect of chemotherapy and radiation therapy in cancer patients.

What Are the Symptoms of a Blocked Tear Duct?

• The white part of the eye turns reddish.

• Blurred vision.

• Blepharitis (edges of the eyelid appear inflamed and scaly).

• Swelling near the eye’s corner.

• Mucus or pus discharge from the eye.

• Conjunctivitis.

• Pain.

• In case of bacteria-induced tear duct blockage, fever is seen.

How Does Tear Duct Blockage Happen?

Tears are produced from the lacrimal glands situated on the inner side of the upper lids. The tears produced by the gland will get drained through the puncta (tear duct) located on the corners of the eye. It travels through the lacrimal sac and nasolacrimal duct and drains in the nose, where it gets reabsorbed. When the puncta are blocked, tears do not drain and cause watery eyes resulting in infections.

What Are the Risk Factors of a Blocked Tear Duct?

• Scarring of the tear duct caused by eye surgery in recent times.

• Age is a common risk factor. Due to age-related changes, the tear duct may get blocked.

• Topical eye medications used in treating glaucoma, cataracts, etc., increase the risk of blocked tear ducts.

How to Diagnose a Blocked Tear Duct?

Physical Examination:

First, the doctor will examine the eyes and the inside of the nose to see if there is any structural obstruction. To confirm a blocked tear duct, the patient will undergo a few tests.

Diagnostic Tests:

• Tear Drainage Test: As the name suggests, this test detects how fast the tears get drained. A drop of special dye is added near the tear duct. If it is seen after 5 minutes, tear duct blockage is confirmed.

• Eye Imaging Tests: A special dye is passed into the tear duct and is observed on X-Ray like computerized tomography (CT) and magnetic resonance imaging (MRI) to find the block and cause of the block.

• Irrigation and Probing: The doctor will flush the duct with saline solution to see how well it is draining. Otherwise, a slender probe is inserted into the tiny opening of the duct to check the presence of a blockage. In most cases, probing resolves the condition by removing the blockage.

How to Manage Blocked Tear Ducts?

Management solely depends on the causative factor.

• If a tumor is causing the blockage, either surgical removal or shrinkage of the tumor is recommended by the doctors.

• If an infection is diagnosed as the cause, doctors prescribe antibiotic medication or eyedrops.

• Dilation, Probing, and Flushing: This is a simple procedure that offers a minimum of temporary relief. The doctor dilates the tear duct opening and probes it to relieve the blockage.

• Stenting or Intubation: A small tube is inserted into the duct for the tears to drain correctly. A small portion of the tube will be evident outside. It will stay intact for at least three months.

• Snip Punctoplasty: A few small incisions are made on the puncta to enlarge the opening for the tears to drain. Partial blockages are usually managed by this method.

Management of Blocked Tear Ducts in Children

• Infants are often born with a blocked tear duct. It is found to resolve as the ducts mature in a few months. If it does not heal, the doctor will ask the attendee to perform a special massage to remove the membrane covering the opening.

• Dilation, probing, and flushing are done in children also but under general anesthesia. The puncta are dilated to insert a probe into the duct and relieve the blockage.

Surgical Management:

Dacryocystorhinostomy is the surgical procedure done to manage the blocked tear ducts. The procedure varies with the site of the block. It is done under general anesthesia. It involves creating a new path for the tears to drain through the nose.

Procedure: A small incision is made on the inner side of the nose to connect the lacrimal sac and nasal cavity. A stent is placed on the new pathway, and the skin is closed with sutures. After six weeks, the stent will be removed by the doctor. This procedure can be done with an endoscopy too. Post-surgery, nasal decongestants and eye drops will be prescribed.

What Are the Complications of a Blocked Tear Duct?

Once the tear duct is blocked, the tears are retained, causing watery eyes. The retained tears promote the growth of bacteria, viruses, and fungi resulting in eye infections.

How to Prevent Tear Duct Blocks?

• It is best to seek a doctor as soon as an infection occurs.

• Wash hands frequently and adequately.

• Do not use expired eye cosmetics like mascara, kajal, and eyeliners. Better to change it every three to five months.

• Proper handling of contact lenses as per doctor’s instructions.

• Avoid sharing eye cosmetics and eye drops.

Conclusion

This condition is not to be worried about. It shows incredible improvement with treatment, and the medical facilities available are enormous. Seeking a doctor as soon as the first sign appears will reduce the complications significantly.