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Function of tears and tear ducts | What happens when a tear duct is blocked? | Treatment

Function of tears and tear ducts

Tears help keep a person's cornea healthy and moistened. Tears are made by the lacrimal glands, which are located under the outside part of the upper eyelid and along the inner surfaces of the upper and lower lids. Tears empty into the eye where they are spread across the cornea by blinking. Then the excess tears are funneled along the lower edge of the eyelid into small canals that lead to a series of ducts that drain the tears away from the eyes to the nose. A blockage that occurs anywhere along this duct system can cause the baby's eyes to water.

What happens when a tear duct is blocked?

Sometimes when a baby is born, its tear ducts are not completely open. The blockage is usually due to a membrane that stretches across one of the small tear ducts. Because the duct is blocked, tears spill out onto the baby's cheek. Although the excess tears may irritate the skin, they don't interfere with the child's visual development.

Tears contain mucus as well as water. As the watery part of the tears evaporates, the mucus dries and may cause the child's eyelids to stick together in the morning or after a nap. Dried mucus may also be found on the cheek around the eye. There may be a lot more dried mucus present when the child has a cold. The presence of excess tears and mucus can cause the eyelids to get red and swollen and become mildly infected.

If your child is experiencing some of the symptoms described here, it does not necessarily mean your child has blocked tear ducts. However, if the child experiences one or more of these symptoms, you should contact your eye doctor for a complete exam. Click here for information on emergency or immediate care.

Treatment

Treatment for blocked tear ducts depends on the age of the infant and the severity of the blockage. Most of the time blockages go away as the child grows, so doctors tend to delay surgery to correct the problem until the child is at least one year old.

The most common form of treatment for blocked tear ducts is massage. The parent massages the tear sacs by gently pressing his or her fingertip between the bridge of the nose and the eye. This is done for several seconds two or more times per day. The massage may force blocked material out of the lacrimal sac so it can be wiped away. In addition, massage may break open the membrane causing the blockage.

If an infection is present, antibiotic eyedrops and ointments can help control the infection. Antibiotics may also control the amount of mucus that is present. Antibiotics will not cure the blockage. Antibiotics are used only if the child's eyelids are red and swollen or if the mucus discharge is extremely heavy.

If massage doesn't work, or if there are repeated infections, the doctor may decide to open the ducts up with a probe. A thin wire is passed through the opening to the tear duct and down through the duct to break open the membrane. No cutting is required. After probing the duct, the surgeon will put fluid into the opening to make sure the passageway to the nose is clear. This procedure takes only a few minutes and complications are rare. The child is usually ready to go home within an hour. The procedure can be done on very young infants in the doctor's office without anesthesia. If it is done after the child is a few months old, it must be done under anesthesia in an operating room.