Overview
When a tear duct is blocked, tears can't drain in the usual way, causing the eye to be watery and irritated. The condition is caused by a partial or complete blockage in the tear drainage system.
A blocked tear duct is common in newborns. The condition usually gets better without any treatment during the first year of life. In adults, a blocked tear duct may be due to an injury, an infection or, rarely, a tumor.
A blocked tear duct can almost always be treated. Treatment depends on the cause of the blockage and the age of the affected person.
Tear glands and tear ducts
Tear glands, also called lacrimal glands, located above each eyeball continuously supply tear fluid that's wiped across the surface of the eye with each blink of the eyelids. Excess fluid drains through the tear ducts into the nose.
Symptoms
Symptoms of a blocked tear duct include:
- Very watery eye.
- Redness of the white part of the eye
- Eye infection or irritation that happens again and again, known as pink eye.
- Painful swelling near the inside corner of the eye.
- Crusting of the eyelids.
- Mucus or pus discharge from the lids and surface of the eye.
- Blurred vision.
When to see a doctor
See a healthcare professional if your eye tears constantly for several days or if your eye is infected often or all the time. A blocked tear duct may be caused by a tumor pressing on the tear drainage system. Finding the tumor early can give you more treatment options.
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Causes
Blocked tear ducts can happen at any age, from birth to adulthood. Causes include:
- Blockage at birth. Many infants are born with blocked tear ducts. The tear drainage system may not be fully developed or there may be a problem with a duct. Often, a thin tissue membrane remains over the opening that empties into the nose, called the nasolacrimal duct.
- Age-related changes. As people age, the tiny openings that drain tears, called puncta, may get narrower, causing blockage.
- Infection or inflammation. Long-standing infection or inflammation of the eyes, tear drainage system or nose can cause the tear ducts to become blocked.
- Injury or trauma. An injury to the face can cause bone damage or scarring near the drainage system. This can affect the typical flow of tears through the ducts. Even small particles of dirt or loose skin cells lodged in the duct can cause blockage.
- Tumor. A tumor in the nose or anywhere along the tear drainage system can cause blockage.
- Eye drops. Rarely, long-term use of certain medicines, such as eye drops used to treat glaucoma, can cause a blocked tear duct.
- Cancer treatments. A blocked tear duct is a possible side effect of chemotherapy medicine and radiation treatment for cancer.
How the tear drainage system works
The lacrimal glands produce most of the eyes' tears. These glands are located inside the upper lids above each eye. Typically, tears flow from the lacrimal glands over the surface of the eye. Tears drain into openings called puncta on the inside corners of the upper and lower eyelids.
The puncta lead to small canals called canaliculi. Canaliculi move tears to a sac on the side of the nose called the lacrimal sac. From there, tears travel down the nasolacrimal duct and drain into the nose. Once in the nose, tears are absorbed again.
A blockage can happen at any point in the tear drainage system, from the puncta to the nose. When that happens, tears don't drain properly, causing watery eyes and increasing the risk of eye infections and irritation.
Risk factors
Certain factors increase the risk of developing a blocked tear duct:
- Age. Older adults are at increased risk of developing blocked tear ducts due to age-related changes.
- Ongoing eye inflammation. If the eyes are constantly irritated, red and inflamed, there is a higher risk of developing a blocked tear duct.
- Previous surgery. Previous eye, eyelid, nasal or sinus surgery may cause scarring of the duct system, possibly resulting in a blocked tear duct later.
- Glaucoma. Antiglaucoma medicines are often used on the surface of the eye. Medicines like these are called topical medicines. If you've used antiglaucoma or other topical eye medicines, you're at higher risk of developing a blocked tear duct.
- Previous cancer treatment. If you've had radiation or chemotherapy to treat cancer, particularly if the radiation was focused on your face or head, you're at higher risk of developing a blocked tear duct.
Complications
Because tears aren't draining the way they should, the tears that remain in the drainage system become stagnant. This promotes growth of bacteria, viruses and fungi, which can lead to frequent eye infections and inflammation.
Any part of the tear drainage system, including the clear membrane over the eye surface, known as the conjunctiva, can become infected or inflamed because of a blocked tear duct.
Prevention
To reduce the risk of developing a blocked tear duct later in life, get prompt treatment of eye inflammation or infections. Follow these tips to avoid eye infections in the first place:
- Wash your hands thoroughly and often.
- Try not to rub your eyes.
- Replace your eyeliner and mascara regularly. Never share these cosmetics with others.
- If you wear contact lenses, keep them clean according to recommendations provided by the manufacturer and your eye care specialist.
