Blocked tear ducts: when crying gets difficult

Understanding blocked tear ducts

Blocked tear ducts occur when an infection, injury, or underlying eye condition causes the tiny passage in the corner of your eye to close up or become "blocked." Your tears actually drain into a reservoir called the punctum and flow into another duct inside your nose.

When the punctum becomes blocked, tears build up and cause constant eye watering, irritation, and discharge. This overflow can occur at any time, even when you're not crying during a sad movie or laughing so hard that your eyes start watering. While clogged tear ducts can be uncomfortable, they're usually pretty easy to diagnose and treat and sometimes resolve without treatment. 

What is a blocked tear duct?

A blocked tear duct is a common eye condition in which the tear ducts become clogged or narrowed. Infections, aging, heredity, injuries, and nasal tumors are some common causes of the condition. Clogged tear duct symptoms include constant eye tearing, itchiness, inflammation, and eye discharge, and the condition is treatable with medications, non-invasive medical procedures, and surgery. 

Tear ducts play an important role in your overall eye health. First, they keep the eyes lubricated and protect the delicate eye tissue from external irritants. Tears start in the glands right above your eyes. When you blink, your tears spread across your eye and then drain into the tear ducts and down through your nose. When the tear ducts are blocked, it can cause the natural tearing process to go a little haywire. 

Causes of blocked tear ducts

Blocked tear ducts can have several possible causes, ranging from congenital blockages in newborn babies to recurring eye infections. If your eyes are chronically inflamed due to allergies or dry eye conditions, this can also cause your ducts to clog up. 

Facial injuries that damage the nasal bone or cause internal scarring can sometimes affect tear flow and lead to clogged tear ducts. Nasal tumors that develop anywhere on the tear drainage system can also prevent proper tear flow and increase the risk of blockages. 

Recognizing symptoms of a blocked tear duct 

Blocked tear ducts have many symptoms that can often be mistaken for dry eyes or irritation from allergens or irritants like cigarette smoke or dust. Recognizing the symptoms of a blocked tear duct is an important first step toward receiving effective treatment. Here are some common symptoms.

Excessive tearing and watery eyes

Watery, irritated eyes that tear up a lot are the most common symptoms of a blocked tear duct. This type of eye watering or tearing is different from emotional crying or when your eyes start to water after eating something spicy or coming in contact with an external irritant.

If your eye suddenly starts tearing up or watering with no obvious cause (first make sure Titanic isn't playing in the background), you might have a blocked tear duct. To make sure, it's always best to schedule a checkup with your eye care professional. 

Eye discharge and crusting

Blocked tear ducts can sometimes cause discharge that crusts up on the eyelids. You might also notice a pus-like discharge on the eyelids or the surface of your eye. This discharge may also disrupt your vision. 

With blocked tear ducts, it's important to note the consistency, color, and quantity of your eye discharge. The color can range from clear to yellow or green, and it may have a sticky, thick consistency. Unlike normal tearing or eye watering, blocked tear ducts tend to water or drain constantly. 

Recurrent eye infections and irritation

Along with discharge and crusting, blocked tear ducts may also cause redness, pain, and swelling around the eye and corner of your nose. The whites of your eyes may be bright red, and your vision might be a little blurry. Recurring eye infections such as conjunctivitis (pink eye) may also indicate a blocked tear duct. 

If your eyes are constantly irritated, itchy, or infected, it's important to schedule an appointment with an eye care professional as soon as possible. Even if it turns out you don't have a blocked tear duct, you may have another type of infection or condition that needs treatment.

Treatment options for blocked tear ducts

Conservative management and home remedies

In some situations, mild blockages can be treated conservatively by "watching and waiting" and using home remedies. If your blocked tear duct is caused by an injury, your eye care professional may recommend waiting a couple of months to see if it heals on its own once your injury heals.

Home remedies are another possible option for blocked tear ducts that aren't infected or causing pain. Gently massaging the side of the nose where it meets the corner of your eye may help to open the tear duct naturally. Applying warm compresses to the eye area might also help encourage drainage and promote healing.

Medical intervention and procedures

In some cases, blocked tear ducts that don't clear on their own can be successfully treated with antibiotics or steroid eye drops. Antibiotics will help clear up any bacteria and underlying infections, and steroid eye drops can help reduce swelling and inflammation. 

If your eye care professional thinks medical intervention is necessary for your recovery, they may recommend a few different procedures.

Balloon catheter dilation

With a balloon catheter dilation procedure, a tube holding a balloon is threaded through the tear duct via your nasal opening. Once the tube is inside the tear duct, the provider will inflate and deflate the balloon to help release pressure and open the blocked duct. 

Tear duct probing and flushing

Tear duct probing and flushing is a minimally invasive procedure that's used on both children and adults. A special tool called a probe is used to open or "dilate" the tear duct opening, and the blockage is flushed out or irrigated. While probing and flushing can definitely help you feel better quickly, the results may only last for a short time and you may need additional treatments. 

Surgical options for severe cases

If your tear duct is severely blocked or if past treatments such as medications or drainage procedures didn't work as you had hoped, your eye care professional may recommend surgery. Dacryocystorhinostomy (DCR) surgery is the most common type of surgery for blocked tear ducts, and the methods include external and endoscopic. 

External DCR surgery

During an external DCR procedure, the surgeon creates a small incision on the side of the nose. Next, the surgeon connects a small tube between the nasal cavity and the lacrimal duct (the tear duct that collects your tears right before they fall from your eyes). Once the two areas are connected, a stent is placed inside the tube to help drain your tear duct. 

Endoscopic DCR surgery

During an endoscopic or endonasal procedure, your surgeon will insert a tiny camera into your nasal opening to locate the blockage in your tear duct. Once they find the blockage, the surgeon will then use small surgical tools to treat the blockage. 

Endoscopic procedures are less invasive than external procedures because the surgeon goes in through your nasal cavity and doesn't make any incisions. However, endoscopic surgery success rates are lower than external surgery success rates. Because of this, it's important to talk to your health care provider about both procedures to determine the best option to suit your needs. 

Managing and treating blocked tear ducts

A blocked tear duct can range from a mildly uncomfortable condition that goes away on its own to a medical emergency that requires surgery. If you're experiencing symptoms of a blocked tear duct, it's important to consult with your eye care professional to determine the best course of action to ensure a successful recovery. 

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FAQs

How long does it take to recover from tear duct probing or DCR surgery?

The recovery time for tear duct probing or DCR surgery is around 8 weeks or so, but you should probably start feeling much better after the first week. You may have some facial bruising that lingers for a while, and your eye care professional might prescribe antibiotics to prevent infection. After your procedure, your eye care professional will give you aftercare instructions to make your recovery easy. 

Is surgery the only solution for severe cases of a blocked tear duct?

While your eye care professional may suggest surgery if your tear duct is severely blocked, there are many other non-surgical treatment options. Your specific treatment plan will depend on the underlying cause and severity of the blockage. Some alternatives to surgery include flushing and draining the tear ducts and antibiotics to clear up any infections that may be causing the blocked duct. In some cases, blocked tear ducts clear up on their own without any type of medical treatment. 

Are there any home remedies that can help alleviate symptoms?

It's super important to consult with your eye care professional before using any home remedies to alleviate blocked tear duct symptoms. If they give you the okay, some helpful home remedies include warm compress applications, cleaning the affected area with saline solution, and massaging the eye area.