A blocked tear duct is a common condition where the tiny drainage system that carries tears from your eyes to your nose gets clogged. Normally, tears wash across your eye and drain out through small openings (puncta) in the inner corners of your upper and lower eyelids. From there, they travel through small canals and a main tear duct (nasolacrimal duct) into the back of your nose. When this system is blocked, tears have nowhere to go, leading to a watery, often irritated eye.
Infants: Very common (about 20% of newborns). It’s usually due to an underdeveloped or narrow drainage system that often opens up on its own within the first year of life.
Adults: More common in older adults, especially women, due to age-related changes, chronic eye infections, or other health conditions.
The main sign is a watery eye (epiphora), but other symptoms include:
Constant tearing and overflowing tears onto the cheek.
Redness and irritation of the skin on the lower eyelid.
Crusting on the eyelashes.
Mucus or pus-like discharge in the eye.
Recurrent eye infections (conjunctivitis) or infections of the tear sac (dacryocystitis), which can cause pain, swelling, and redness in the inner corner of the eye.
Blurred vision.
Causes differ for infants and adults:
Age-Related Changes: Ducts naturally narrow with age.
Infection or Inflammation: Chronic sinusitis or eye infections can cause scarring.
Injury or Trauma: To the face or nose that damages the drainage system.
Tumors: In the nose or lacrimal system (rare).
Other Medical Conditions: Such as sarcoidosis or Wegener’s granulomatosis.
Most often, it’s a congenital blockage where the thin membrane at the end of the tear duct fails to open at birth.
An eye doctor (ophthalmologist) will:
Examine your eye and ask about your symptoms.
Perform a tear drainage test: They may place a drop of special dye in your eye to see how long it takes to drain. If it remains for a long time, it suggests a blockage.
Irrigate and probe the duct: They may flush a saline solution through the duct to see if it comes out in the back of the nose. This can also sometimes clear a minor blockage.
Order imaging (in complex cases): A dacryocystogram is an X-ray that uses dye to map out the exact location of the blockage.
Treatment depends on the cause, severity, and your age.
Watchful Waiting & Massage: Most clear up on their own by 12 months. The doctor may teach you a special Crigler massage technique to help open the membrane.
Probing: If it doesn’t resolve, a doctor can gently probe the duct to open it. This is a simple, effective procedure done under general anesthesia.
Conservative Treatment: For minor inflammation, warm compresses and antibiotic eye drops can help with infections.
Minimally Invasive Procedure: Balloon Catheter Dilation. A tiny balloon is inserted and inflated to widen the duct.
Surgery (Dacryocystorhinostomy – DCR): This is the gold standard for permanent blockages in adults. A surgeon creates a new drainage pathway from the tear sac directly into the nose, bypassing the blocked duct. This can often be done through the nose (endonasally) without an external scar.
While not always dangerous, a chronically blocked tear duct can lead to frequent, painful eye infections and significantly impact your quality of life. Successful treatment resolves the tearing and drastically reduces the risk of infection.
If you have a persistently watery or irritated eye, it’s important to see an eye doctor to get the correct diagnosis and find the best treatment for you.
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