Tear duct obstruction is a very common problem in infants and frequently, within the first five or six months of life, it clears up on its own but also occurs in adults. The tear system in our eyes is like a shower system. Each eye has a tear gland that is continually making tears, even when we are not crying, and a tear duct (or drain pipe) to drain tears out of the eyes and into the nose – this is why we get a runny nose when we cry. When the tear ducts do not clear up on their own, tear duct surgery may be required.
Some children are born with a blockage in the bottom of the tear duct and the result is similar to what happens when a shower drain is blocked. Excess tearing in adults may be caused either by poor tear drainage or an overproduction of tears.
Tears are produced in the tear gland. By lubricating the eyes, tears play a vital role in the maintaining the health of the eye. When the eye is irritated excess tears are produced. People are not always aware of the eye irritation, but instead may notice the overproduction of tears. Tears normally drain into small holes located in the inside corner of the upper and lower eyelids. The tears then collect in the tear sac. The tear sac lies under the skin between the corner of the eye and the nose. Next, the tears flow through a small tube, called the nasolacrimal duct, into the nose. The tears are pumped through this drainage system by the opening and closing of the eye. A blockage in any part of this drainage system can prevent tear drainage and lead to excess tears running out of the eye and down the cheek.
Tear Duct Surgery and Treatment
- When the nasolacrimal duct, the tube which drains tears into the nose, is blocked a surgical procedure is usually required. During this procedure, called a DCR (Dacryocystorhinostomy), a hole is created between the tear sac and the inside of the nose.
- When the nasolacrimal duct is only partially blocked your doctor will often attempt to widen the opening by flushing water through the duct. An eyedrop with both anti-inflammatory and antibiotic medications will then be prescribed in an attempt to reduce the swelling in the duct and promote tear drainage. These attempts to open the duct are often successful but may need to be repeated periodically
- When the tubes, called cannaliculli, which drain the tears into the lacrimal sac are blocked surgical therapy is required but far more complicated. In most cases both a DCR and reconstruction of the cannaliculli will be performed.
- Eyelid weakness or malposition may be treated by surgically tightening and repositioning the lids.