Carl R. Darnall Army Medical Center - Health Library

Lacrimal Duct Stenosis

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

Pronounced: La-cree-mahl duct sten-oh-sis

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.

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Causes ^

In some babies, problems in normal development of the tear duct can cause lacrimal 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 ^

You will be asked 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 if it persists.

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 and open the membrane. You will also do this at home 3 times a day until the tear duct has opened.
  • Probing—If the blockage is present at 1 year old the eye 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.

Prevention ^

There are no current guidelines to prevent lacrimal duct stenosis.

RESOURCES:

Healthy Children—American Academy of Pediatrics
http://www.healthychildren.org

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

CANADIAN RESOURCES:

Canadian Ophthalmology Society
http://www.cos-sco.ca

Caring for Kids—Canadian Pediatric Society
http://www.caringforkids.cps.ca

REFERENCES:

Nasolacrimal duct obstruction. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T113767/Nasolacrimal-duct-obstruction. Updated May 31, 2017. Accessed December 14, 2017.

Tear duct obstruction and surgery. Kid's Health—Nemours Foundation website. Available at: http://kidshealth.org/parent/general/eyes/tear_duct_obstruct_surgery.html. Updated February 2015. Accessed December 14, 2017.

Last reviewed December 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP  Last Updated: 12/20/2014