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Tear Duct Obstruction


Tears normally drain from the eye through small tubes called tear ducts that stretch from the eye into the nose. A blocked tear duct occurs when the duct that normally allows tears to drain from the eyes is obstructed or fails to open properly. If a tear duct remains blocked, the tear duct sac fills with fluid and may become swollen and inflamed, and sometimes infected.

The tear drain consists of two small openings called punctum; one in your upper eyelid and the other in your lower eyelid. Each of these openings leads into a small tube called the canaliculus which, in turn, empties into the lacrimal sac between the inside corner of your eye and your nose.  The lacrimal sac leads into a canal called the nasolacrimal duct that passes through the bony structures surrounding your nose and empties tears into your nasal cavity. The most common symptoms are excessive watering, mucous discharge, eye irritation, and  painful swelling in the inner corner of your eyelids. Your surgeon may recommend a number of treatments based on the analysis of your symptoms.

Causes of blocked tear duct include:

  • Remodeling of the boney skull
  • Age
  • Foreign bodies
  • Previously placed punctal plug
  • Infections
  • Tumors
  • Trauma
  • Previous sinus surgery
  • Radiation and chemotherapy

Treatment consists of evaluation in the office to determine the point of blockage. This usually is followed by surgery. The type of surgery is determined by the location and cause of the obstruction.


Punctal Occlusion

The puncta is the small opening found on the edge of the upper and lower eyelids next to the nose. Tears drain out of the eye through the puncta into the nose. This is why your nose runs when you cry. If you aren't producing enough tears then you don't want the tears that you are producing to be drained away. Punctal occlusion is painless and performed in the office, taking only a couple of minutes.