Tear Duct Blockage and Surgery

If a partial or complete blockage occurs in the tear drainage system, the tear cannot drain normally out of the eye and accordingly, various complaints are experienced. Tear duct blockage may occur congenitally or due to past trauma, infections, or tumor formation. Treatment of tear duct blockage is planned depending on the factor that blocks the tear duct.

What is Tear Duct Blockage?

The tear sac and ducts are responsible for conveying the tear to the nasal cavity. A blocked duct may damage the functions of the tear drainage system. This is called “tear duct blockage”. Since tears tend to drain continuously out of the eye in patients whose tear ducts are blocked, inflammation and swelling occur in the tear sac over time. A blockage that occur in the nasolacrimal ducts, i.e. the ducts the convey the tear from the sac to the nose, may lead to watering of eyes.

What are the Causes of Tear Duct Blockage?

Congenital Blockage: Many neonates may experience tear duct blockage, since tear duct development has not been completed yet.
The narrowing of the openings called “puncta” where tear drainage occurs with advancing age may lead to tear duct blockage.
Chronic infection occurring in the nose, tear drainage system or eyes may block the tear ducts.
Trauma may damage tear ducts and lead to tear duct blockage.
Tumors formed in the nose or near the tear drainage system may cause tear duct blockage.

In addition to all these reasons, I can say that tear duct blockage may also occur in those who receive cancer treatments such as chemotherapy, radiotherapy, and use eye drops for a long time.

How is Tear Duct Blockage Treated?

Recurrent eye infections may occur in case of problems with tear drainage mechanism. Surgical treatments are generally used if the cause of watering eyes is determined to be tear duct blockage.

Surgical treatment is considered as the last option for neonates. The first step of treatment in neonates is to massage down the nasal root several times a day in the first year. If the duct does not open spontaneously, the procedure called “probing” may be performed. If minimally invasive treatments do not work, surgical options are taken into consideration.

Tear duct blockage surgery, which is applied under general anesthesia, is no longer performed by ophthalmologists, but by ENT physicians endoscopically by entering through the nose without external incision and not breaking the nose, and using laser system. During the procedure, the laser probe is used to enter through the eye puncta; when the nasal wall and tear sac are reached, laser beam reflection is taken endoscopically on the nasal wall and the relevant area is burned and expanded. There is no incision, suture, significant bleeding, bruising or swelling. Silicon probes are attached to the expanded area and they remain in place for several months to maintain the opening of the tear duct. Then, the silicon probes are easily taken from the nose.