A blocked tear duct (nasolacrimal duct) is a condition in which the tear drainage pathway in the eye is partially or completely blocked, resulting in difficulty in draining tears from the lacrimal glands. Blockage of the tear ducts is common in children, affecting six out of 10 newborns, and usually resolves on its own in these cases.1 In children, the tear duct may not develop completely at birth. They may be closed or covered with a thin film, causing partial blockages. However, adults can also suffer from a blocked tear duct. Adults with blocked tear ducts need medical help. In these cases, the canal may be damaged by an infection, injury or tumor.

Symptoms of obstruction of the tear duct in adults

Tears usually flow from the eye through the nasolabial ducts, which are small tubes that run from the eye to the nose. If the tear duct is blocked or its opening fails, tears cannot leak out of the eye properly. The duct may then fill with fluid and become swollen, inflamed, and sometimes inflamed.

Symptoms of obstruction

The main symptom is increased tearing (epiphora), which causes tears to flow on the face or cheek. Sometimes, tears may seem thicker. Eyes may also become dry and scaly

Symptoms of a blocked tear duct may worsen after a cold or sinusitis. They may also become more noticeable after exposure to cold, wind, or sunlight

Symptoms of infection

When the lacrimal ducts are blocked, bacteria trapped in the nasolacrimal sac can lead to an infection called lacrimal sac inflammation. In severe cases, the infection can spread to the eyelids.

Symptoms include:

• Inflammation, pain and redness in the inner corner of the eye or around the eye and nose
• Recurrent eye infections
• Drainage of eye mucus
• Flaky eyelashes
• Blurred vision
• Tears torn with blood
• fever
• It’s important to reach out to your eye care provider for diagnosis and treatment if you have signs of infection.

Causes

In adults, blockage of the tear ducts may be caused by injury to the bones or tissues around the eyes or by another disorder.

Causes of blocked tear ducts in adults include: 5

• Abnormal development of the skull or face: Those with skull or facial deformities, such as Down syndrome, are more likely to develop a blocked tear duct.
• Nose injury: In nasal injuries, such as a broken nose, scarred tissue can block the tear duct.
• Nasal polyps: Polyps are growths in the lining of the nose (which affect some people with nasal allergies) that can block the lacrimal duct system.
• Tumors: It may put pressure on the tear duct itself and prevent discharge.
  Age-related changes: Changes such as narrowing of the dot openings, small openings in the inner eyelid, can cause blockage of the tear ducts.
• Conjunctivitis: It is an inflammation of the conjunctiva, the mucous membrane that lines the inner surface of the eyelids and the front of the eye. In some cases, conjunctivitis may cause rupture due to inflammation.

diagnosis

• Your eye doctor (ophthalmologist or ophthalmologist) will first perform a full medical examination of the eye. They will also discuss your medical history and examine your eyes thoroughly to check for other possible causes of your symptoms.
• To check for blockages in the tear duct, they will conduct a dye disappearance test. One drop of special dye is placed in each eye. If a large amount of pigment persists in your eye five minutes after normal blinking, you may have a blockage in the tear duct.
• In complex cases, your doctor may order an x-ray of the tear duct area. Specifically, they will take the diagram of the lacrimal cyst, which involves injecting a radioactive dye into the tear duct. This contrast factor allows your doctor to see the blockage inside the tear duct.

Treatment

Treatment varies depending on the cause of the blockage of the tear duct. If your condition is caused by a facial injury, the drainage system begins to work on its own a few months after the injury, and no additional treatment is required. In other cases, your doctor may recommend medications or surgery

Antibiotics

If an infection is suspected, your doctor will prescribe antibiotics. In severe cases, people with a tear duct infection may need intravenous antibiotics and hospital monitoring. Antibiotic ointment for the eye or eye drops may be prescribed in some cases. However, chronic inflammation can be difficult to treat without surgery to widen the drainage duct of the tear duct.

Do not apply an over-the-counter antibiotic ointment that is not specifically designed for use in the eye in the eye or surrounding area. These drugs are not made for use in the eye and can contain irritating ingredients.

Expanding, sounding and watering

For adults who have a partially blocked channel or partial narrowing of the lacrimal points, this technique can be used.6 A tool is used to expand the point openings, and a narrow probe is guided through the points, into the tear drainage system, and then through the nostril before being removed. The tear drainage system is washed with saline solution to remove any remaining blockages.

Catheter balloon dilation

The balloon catheter dilatation process opens tear drainage passages that narrow or block due to scarring or inflammation. 6 Your doctor will pass a thin, wire-like probe about 2-3 mm (millimeters) wide with a bulging balloon on its tip through the blocked tear duct and into the nasal cavity. Then they inflate and empty the small balloon with sterile saline solution several times to open the blockage and expand the tear duct. This is done under general anesthesia.

Supports

In this procedure, also called tear duct intubation, small tubes are used to open narrow passages within the tear drainage system. Tear drainage system and to the back of the nose. A small ring of tubes is left in the tear duct. Although it may be visible, it is usually not annoying. These tubes are generally left for three to four months, then removed. This approach also requires general anesthesia.

surgery

If the above treatment options are not enough to open the blocked tear duct, your doctor will recommend surgery, usually a lacrimal cyst ostomy. This procedure creates a new path for tears to come out of your nose. This new section bypasses the nasolacrimal canal, where blockage usually occurs. The stents are usually placed in the new path and left there during recovery. They are removed three or four months after surgery. The steps in this procedure may vary for your tear duct obstruction problem

Depending on the type of blockage, your surgeon may recommend creating an entirely new path from the lacrimal points to your nose, bypassing the tear drainage system altogether. This reconstruction of the entire tear drainage system is called conjunctival rhinostomy.

If the tumor causes a blockage of the tear duct, surgery is performed to remove it. Or your doctor may suggest using other methods, such as chemotherapy or radiation therapy, to shrink it.

Postoperative care

To prevent infection and inflammation after surgery, you will need to use nasal decongestant sprays and eye drops. After about three to six months, your eye doctor will remove any stents that have been placed to keep the new duct open during healing.

A word from Ibsar Specialized Center

Blocked tear ducts can be annoying and annoying, but they can be managed and repaired depending on their severity. Tear duct obstruction is a common problem in children, but it can also occur in adults. Some causes of blocked tear duct will resolve on their own, but others require antibiotics and even surgical treatments. The earlier the tear duct is treated, the better your results and quality of life will be. If you have eye tears and other symptoms of tear duct obstruction, talk to an optician about diagnosis and treatment.