Tear Duct Obstruction

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What is a tear duct obstruction?

There is a drainage system to clear moisture from the eye. The final drain pathway is a tube, called the tear duct, that drains into the nose where the tears flow down onto the back part of the tongue and are eventually swallowed. The most common reason for overflow of tears and discharged in infants is a tear duct obstruction.

What are the symptoms of a tear duct obstruction?

The presenting signs of a tear duct obstruction are tearing and mattering without conjunctivitis or red eye. The over abundance and spontaneous overflow of tears is a common problem in infant’s occurring in up to 25%. The signs of excessive tearing and discharge may be present within the first few weeks of life. In other cases, overflow tearing may not be obvious for 3-4 months.

What happens to tear duct obstructions in infant?

The most common cause of excessive tearing in an infant is a tear duct obstruction. A great many infants, more than 90%, will show spontaneous resolution of the tear duct obstruction by 6-9 months of age. Thereafter, the likelihood of clearing without surgical intervention is very low. Therefore, there is very little benefit in delaying the surgical treatment past 9 months of age.

How is a tear duct obstruction surgically treated?

A probing and irrigation procedure is recommended as the initial surgery to treat chronic tear duct obstruction that persists after 9 months of age. To be performed accurately and safely, this brief, outpatient procedure requires the use of general anesthesia. The success rate – the elimination of tearing and mucus in the eye – following the probing and irrigation procedure for tear duct obstruction is about 80% when performed before 14 months of age. For those children who failed a probing and irrigation or are treated at after 15 months of age, there are alternative treatments available including balloon dacryoplasty and the temporary insertion of a tube or stent.

Is all tearing a tear duct obstruction?

Not all tearing in infants is a tear duct obstruction. There are other serious causes of tearing. Infantile glaucoma and corneal problems (such as a scratch or foreign body) may also cause tearing. The symptoms of these problems include tearing, excessive light sensitivity, squinting or blinking, pain, and, in the case of infantile glaucoma, haziness or clouding of the cornea and increased corneal size.

Should I be worried about a tear duct obstruction?

Congenital tear duct obstruction is a very common problem in pediatric ophthalmology. Diagnosis of tear duct obstruction can be made by history and by complete ophthalmologic evaluation to separate this common problem from potentially more serious disorders. Tearing and discharge problems that persist after 9 months require pediatric ophthalmologic surgical intervention. Probing and irrigation is an extremely safe and effective method of treatment.

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