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 eye 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. There is one in your upper eyelid and another in your lower eyelid, both situated at the inner part of the eye near your nose. Each of these openings leads into a small tube called the canaliculus, which 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.
Causes of blocked tear duct include:
- Foreign bodies
- Previously placed punctal plug
- Previous sinus surgery
- Radiation and chemotherapy
Our oculoplastic specialists will determine the point of blockage during an evaluation, then discuss any treatment options they feel are appropriate. Surgery may be necessary, but the type of surgery is determined by the location and cause of the obstruction.
A DCR (dacryocystorhinostomy) is performed in the operating room, typically under general anesthesia, and is an outpatient procedure. The surgeon will create a new tear drain opening from the blocked sac directly into your nose in order to bypass the obstruction. A tiny incision is made (usually on the inside of the nose) and a soft silicone stent may be temporarily left in the new tear drain. This helps the new drain passage stay open while healing, and usually falls out within the first six months after the procedure.