Nasolacrimal Duct Obstruction

A blocked tear duct is also known as nasolacrimal duct obstruction. It is a blockage of the eye’s natural tear drainage system. Tears can “back up” and overflow onto the cheek instead of draining through the tear duct in the eye. 


Normal tear drainage

As we blink, tears are pushed into and through the tear drainage system. Tears drain from the eyes through 2 small openings called the upper and lower puncta, which are located on the upper and lower eyelids near the nose. Tears then flow into a sac located under the skin along the side of the nose. From there, tears flow through a thin tube through the side bones of the nose and empty into the back of the nose. 


Blocked tear ducts in babies

A small membrane (piece of thin tissue) that blocks the lower end of the tear duct where it enters the nose and does not allow tears to drain properly.


Symptoms of a blocked tear duct

  • Excess tearing, even when the child is not crying
  • Yellow discharge from the eye
  • Crusting of the eyelids, especially upon awakening

Treatment for a blocked tear duct 

Observation: This is the most common treatment because a blocked tear duct will usually open on its own as a baby grows.

Massage: Pressure on the nasolacrimal sac between the corner of the eye and the nose can open the membrane. This may allow the tear duct to heal. It can also help release mucous and tears from the tear drainage system preventing infection.

Antibiotic drops: Drops may be prescribed when the discharge from the eye is very heavy. Drops should typically not be used for more than 7-10 days at a time.

Surgery: If the blockage is still present after 1 year of age, surgery can be done.  During surgery a tiny probe is passed through the tear drainage system to open the blockage. The drainage system may be opened with a tiny balloon or a small silicone tube may be temporarily placed in the drainage system to hold it open during healing.  Some surgeons will offer a probing procedure in an office setting with topical anesthesia prior to 1 year of age.