Tearing is a very common problem and represents one of the most prominent symptoms in patients who come to our ophthalmology clinic.
The tear sac drains directly into the nose through the nasolacrimal duct. But sometimes this duct becomes blocked, and the direct consequence is that tears cannot drain normally, leaving the eyes watery and irritated.
Additionally, this obstruction can lead to frequent infections such as dacryocystitis and conjunctivitis. When tears become blocked in the tear duct, they can become infected, causing what is known in ophthalmology as dacryocystitis, which in turn leads to recurrent conjunctivitis, a chronic infection of the eyes and even the surrounding skin.
Blockage in the tear ducts is very common in newborns but also affects adults, possibly as a result of an injury, infection, or tumor.
In children, 90% of cases resolve spontaneously before the first year of life. During this period, treatment consists of massaging the area around the tear duct, maintaining good hygiene in that area, and, if infection is present, administering appropriate antibiotic treatment.
What symptoms do problems with the tear ducts produce?
- Excessive tearing
- Redness of the white part of the eye
- Recurrent eye infection or inflammation (conjunctivitis)
- Painful swelling near the inner corner of the eye
- Crust formation on the eyelids
- Secretion of mucus or pus from the eyelids and surface of the eye
- Blurred vision
What treatments can be carried out?
A blocked tear duct can be corrected, but the most appropriate treatment will depend on the cause of the blockage and the age of the affected person.
Dacryocystorhinostomy is a surgical technique designed to create an additional duct in the lacrimal bone, allowing the lacrimal sac to connect to the nose. This eliminates the obstruction that has developed.
This procedure can be performed traditionally, by making an incision in the skin between the eye and the nose; or endoscopically (DCR), accessing the nasal passages without skin incisions. Once the new communication pathway is established, a silicone tube is inserted through the upper and lower lacrimal puncta and passed through to the nose, where it remains for 3 to 6 months. It is then removed during a routine check-up. The success rate of this technique is over 80% and is similar to that of other techniques such as traditional external DCR.
In either case, the procedure lasts approximately 30 to 45 minutes and can be performed under local anesthesia and sedation. Both techniques are outpatient procedures, allowing patients to return to work as soon as possible.
