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Lacrimal Duct Stenosis

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

How to Say It: La-cree-mahl duct sten-oh-sis

Definition

Lacrimal duct stenosis is a narrowing of a tear duct (lacrimal duct). It can happen 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

This problem happens in some babies when the tear duct does not form as it should. A thin membrane may cover the opening of the duct into the nose.

Risk Factors

Things that may raise the risk of this problem are:

  • Having a face or skull that does not form as it should
  • Down syndrome

Symptoms

Problems may be:

  • Excessive tearing
  • Eye redness, warmth, and swelling
  • Eye irritation
  • Mucous discharge from the eye
  • Crusting on the eyelid

Diagnosis

The doctor will ask about your baby’s symptoms and health history. An eye exam will be done. Your baby may need to see an eye specialist.

The tear duct will be checked for blockages. This can be done with a dye disappearance test. This can confirm the diagnosis.

Treatment

This problem often goes away in the first year of life. If it does not, the goal of treatment is to open the tear duct. They may be done with:

  • 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. This will also need to be done at home until the tear duct has opened.
  • Probing—A tiny probe may be placed into the duct to open it. It may also be dilated with a balloon or stented to keep it open.
  • Surgery—Babies who are not helped by these methods may need surgery. A tiny, flexible instrument will be placed into the tear duct. The doctor may then flush fluid through it. A laser may be used to cut away any blockage.

Prevention

There are no known methods to prevent this health problem.

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 website. Available at: https://www.dynamed.com/condition/nasolacrimal-duct-obstruction-15. Accessed August 19, 2021.

Surgery for tear duct blockage. Kid's Health—Nemours Foundation website. Available at: http://kidshealth.org/parent/general/eyes/tear_duct_obstruct_surgery.html. Accessed August 19, 2021.

Last reviewed July 2021 by EBSCO Medical Review Board James Cornell, MD  Last Updated: 8/19/2021