Lacrimal Duct Stenosis

(Blocked Tear Duct; Nasolacrimal Duct Obstruction; Lacrimal Duct Obstruction; Dacryostenosis)

Definition

Lacrimal duct stenosis is a narrowing of a tear duct (lacrimal duct). This condition can occur in children and adults. This fact sheet will focus on lacrimal duct stenosis in infants.Lacrimal Duct
ao00127 40018 1 lacrimal duct.jpg
The lacrimal duct (in blue) drains tears from the eye down into the nose. The opening of the ducts are near the inner corner of the eye.Copyright © Nucleus Medical Media, Inc.

Causes

In some babies, problems in normal development can cause lacrimal duct obstruction. A thin membrane may cover the opening of the duct into the nose.

Risk Factors

Factors that may increase your baby’s chance of lacrimal duct stenosis:

Symptoms

Lacrimal duct stenosis may cause:
  • Excessive tearing
  • Recurrent red eye or eye irritation
  • Tear duct infection ( dacryocystitis ) causing redness, warmth, swelling around the eye, and discharge with pus
  • Cloudy or mucous-like discharge from the tear duct
  • Crusting on the eyelid
  • Bloody tears

Diagnosis

The doctor will ask about your baby’s symptoms and medical history. The doctor will do an exam. Your baby may need to see a doctor who specializes in eye conditions in children.The eye doctor may do a dye disappearance test. This test will help to confirm that there is a blockage in the tear duct.

Treatment

Talk with the doctor about the best treatment plan for your baby. In infants, this condition often heals by itself in the first year of life.Treatment options include:
  • Massage—The doctor may gently push on the area where the tear duct runs out of the eye, between the baby’s eye and nose. This helps to push tears through the duct. You will also do this at home 3 times a day until the tear duct has opened.
  • Probing—The doctor may pass a tiny probe into the duct to open it up. In some cases, the ducts may be dilated with a balloon or stented to keep them open.
  • Surgery—In some cases, surgery may be needed to open up the duct. In one type of surgery, the doctor puts a tiny, flexible instrument into the tear duct to see what is causing the blockage. The doctor may then flush fluid through the instrument. A laser may be used to cut away the blockage.

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Prevention

There are no current guidelines to prevent lacrimal duct stenosis.

RESOURCES

American Academy of Pediatrics
http://www.healthychildren.org

National Eye Institute
http://www.nei.nih.gov

CANADIAN RESOURCES

Canadian Ophthalmology Society
http://www.eyesite.ca

Canadian Pediatric Society
http://www.cps.ca

References

Blocked tear duct: risk factors. Mayo Clinic website. Available at: http://www.mayoclinic.org/diseases-conditions/blocked-tear-duct/basics/definition/con-20033765. Updated October 2008. Accessed April 22, 2010.

Causes of blocked tear ducts. Nemours Kids Health website. Available at: http://kidshealth.org/parent/general/eyes/tear%5Fduct%5Fobstruct%5Fsurgery.html. Accessed April 22, 2010.

Hurwitz JJ. The lacrimal drainage system. Ophthalmology. 2nd ed. St. Louis, MO: Mosby; 2004: 761-768.

Nasolacrimal duct obstruction. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 8, 2010. Accessed April 20, 2010.

Tearing. The Merck Manual Professional Edition website. Available at: http://www.merckmanuals.com/professional/eye%5Fdisorders/symptoms%5Fof%5Fophthalmologic%5Fdisorders/tearing.html?qt=tearing&alt=sh. Updated April 2009. Accessed April 20, 2010.

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