Blocked Eye Ducts
By Sonja Moolman - B.Optom (RAU)
"My eyes are tearing excessively, and nothing seems to work..."
Your lacrimal glands produce most of your tears. These glands are situated in our upper eye lids. Tears being produced need to drain through the little hole in your upper and lower eye lid corners called the Puncta. The small drainage pipes running from the Puncta called the canaliculi is then draining into your lacrimal sack, and then draining via the nasolacrimal duct system into your nose. Tears gets reabsorbed through the nose.
Blockages can appear along any area of this system and once that happens you can get an eye with a lot of tearing and even infections.
Because the system is compromised and the rate that tears are draining is reduced the tears beg come stagnant and it can promote the growth of bacteria, viruses, and fungi. Any part of the drainage system including the conjunctiva (clear membrane) can get infected.
Symptoms of a blocked system
Redness of the eye
Painful inner corner area of eye
Crusting of eye lids
Congenital: some infants are born with a blocked system - They can outgrow it at the age of 1 year
Chronic infections and inflammation
Injury and trauma to face can cause scarring to the duct system
Long term use of eye drops e.g. Glaucoma drops
Cancer treatments chemotherapy and radiation
Age related changes: as people are ageing the Puncta is decreasing in size
Age and sex - Older women are more at risk
Chronic eye inflammation - Continuous red irritated eyes are more prone to blockages
Previous surgery - Previous eyelid nasal or facial surgery can cause scarring that can in turn cause blockage
There at a few tests that can be performed to diagnose blocked tear duct:
Tear drainage test
Tears are being dyed with a colorant and if after 5 minutes the amount of tears pooling is still same as in beginning a blocked tearduct can be diagnosed.
Irrigation and probing
This is a more invasive test where saline is used to flush out the system and sometimes a probe is used to check for the Blockages.
Eye imaging test
Herewith a contrast dye is used and via CT and MRI Blockages can be determined.
Inflammation and infection needs to be under control: massaging of the eye lids and tear ducts to reduce blockage can be used and using hot compression to soften the blocked areas.
Flushing with saline can be done
Balloon catheter inserted at the Puncta and this opens up the system and drain the excess tears
Stenting and incubation: a small tube is inserted through the Puncta and draining into the nose
Surgery: Dacryocystorhinostomy is a surgery performed under general anaesthesia and opens the ducts to drain into the nose again.
Never touch or rub your eyes with hands that aren’t washed
Women need to replace eye makeup regularly
If you wear contact lenses, always use proper cleaning techniques and routines