The tear drain consists of two small openings called puncta. One in the upper eyelid and the other in the lower eyelid. Each of these openings leads into a small tube called the canaliculus which inturn empties into the lacrimal sac between the inside corner of the eye and nose. The lacrimal sac leads into a canal called the nasolacrimal duct that passes through the bony structures and empties tears into the nasal cavity
How does the tear drain work?
With each blink, the eyelids push tears evenly across the eyes to keep them moist and healthy. Blinking also pumps old ters into the puncta and lacrimal sac where they travel through the tear duct and drain into the nose. If the tear duct is blocked, tears back up and spill over the eyelids and run down the cheek. Tears trapped in the tear sac can become stagnant and infected
What are the symptoms of having a blocked tear duct?
The most common symptoms are excessive watering, mucous discharge, eye irritation and painful swelling in the inner corner of the eyelids. A skillful history and physical examination can usually pinpoint the cause of tearing.
Is congenital lacrimal obstruction serious?
It is important that children with excessive tearing be examined by an ophthalmologist to determine the cause of the problem. In some children excessive tearing may be due to causes other than tear duct obstruction.
What are the treatments?
Initial treatment involves massaging the area around the affected lacrimal sac to force the tears down the nasolacrimal duct and to push open the membrane causing the obstruction. The physician may also prescribe antibiotic or ointment.
If massage doesn’t relieve the obstruction probing may be necessary. Lacrimal probing is usually performed as an outpatient procedure, typically under general anesthesia. A fine metal probe is inserted thorough the punctum and passed down the duct through the obstruction. If the inferior turbinate is blocking the end of the nasolacrimal duct, it can be moved. In severe or recurrent cases, a soft rubber stent can be placed in the orifice. Antibiotic ointment or drops are prescribed after probing.
What are the risks and complications?
Minor bruising or swelling may be expected and will likely get away in one to two weeks. Occasionally , the scar tissue may block the drain again, which may require repeating the procedure. Bleeding and infection, which are potential risks with any surgery, are very uncommon. As with any procedure, there may be other inherent risks that should be discussed with your surgeon.
Is the surgery effective?
Most patients experience resolution of their tearing and discharge after probing is completed with little if any postoperative discomfort.
Who performs the surgery?
Patients are most commonly treated by Paediatric ophthalmologist under short General Anesthesia. Top