Blocked Tear Duct: Causes, symptoms and Treatment

What is a Blocked Tear Duct?

A blocked tear duct occurs when the drainage system that carries tears from your eyes to your nose is obstructed. This condition, known medically as nasolacrimal duct obstruction, prevents tears from draining normally, leading to watery eyes and, sometimes, infections.

While it’s a common issue in newborns, affecting around 6%–20% of infants, it can also occur in adults due to aging, infections, or trauma.

How Does It Occur?

Think of the tear drainage system as a well-designed pipeline. Tears produced by glands in your eyes flow across the surface to keep them moist, then drain through small openings in the corners of your eyelids, called puncta.

From there, they travel down the tear ducts and into the nasal cavity. A blockage in this system, much like a clogged pipe, stops the smooth flow, leading to tear buildup and overflow. This can happen due to inflammation, scarring, or anatomical issues.

What are the Causes of a Blocked Tear Duct?

A blocked tear duct can result from various factors, and understanding the underlying cause is crucial for effective treatment. Here are the most common causes:

1. Congenital Blockage (30%–50%): Many newborns are born with an underdeveloped or blocked tear duct. The condition often resolves on its own within the first year.
2. Infections (10%–20%): Chronic eye infections or sinus infections can cause inflammation and scarring, leading to obstruction.
3. Injury or Trauma (5%–15%): Damage to the tear ducts from facial injuries or surgery can disrupt the tear drainage system.
4. Aging (20%–30%): As we age, the puncta may narrow, making it harder for tears to drain.
5. Tumors or Growths (1%–5%): Rarely, tumors in or near the tear drainage system can block the ducts.
6. Chronic Conditions (e.g., Sarcoidosis or Scleroderma): These systemic diseases can lead to scarring or narrowing of the ducts.

Risk Factors

Some people are more prone to developing a blocked tear duct. These risk factors can make the condition more likely:

• Age: Infants and adults over 60 are at higher risk due to congenital issues or aging changes in the tear ducts.
• Gender: Women are more susceptible, possibly due to narrower tear ducts or hormonal changes.
• Chronic Sinus Issues: Frequent sinus infections can inflame and scar the ducts.
• Facial Trauma or Surgery: Any injury near the eyes or nasal area can disrupt the tear drainage pathway.
• History of Eye Infections: Recurrent infections can lead to scarring of the ducts.
• Tumors: Growths near the eyes or nasal cavity can block the ducts.

Symptoms of a Blocked Tear Duct

How do you know if your tear duct is blocked? Here are the telltale signs:

1. Excessive Tearing (Epiphora): Tears may spill over your eyelids frequently, even without crying.
2. Redness and Swelling: Around the inner corner of the eye, caused by stagnant tears and infections.
3. Recurrent Eye Infections: Chronic conjunctivitis is a common complication.
4. Discharge: Thick, sticky mucus may accumulate in the corner of your eye, especially upon waking.
5. Pain or Tenderness: Infected tear ducts can be painful and tender to the touch.
6. Blurry Vision: Excessive tearing can sometimes interfere with clear vision.

Differential Diagnosis

Since a blocked tear duct shares symptoms with other conditions, it’s important to differentiate it from similar problems:

• Conjunctivitis: While both conditions cause redness and tearing, conjunctivitis often has itchiness and is contagious.
• Dry Eye Syndrome: Paradoxically, this can cause excessive tearing due to irritation, but the underlying issue is lack of moisture.
• Blepharitis: Inflammation of the eyelids can mimic some symptoms but involves crusty debris around the lashes.
• Allergies: Allergic reactions cause watery eyes, but they’re usually accompanied by itching and sneezing.

How to Diagnose a Blocked Tear Duct?

Diagnosing a blocked tear duct involves a thorough examination and specific tests:

1. Physical Examination: The doctor will look for redness, swelling, and discharge around your eyes.
2. Fluorescein Dye Test: A harmless dye is placed in your eye to track the flow of tears. If the dye remains on the surface, it indicates a blockage.
3. Probing and Irrigation: A small probe may be used to test the patency of the ducts.
4. Imaging Tests: For complex cases, CT scans or dacryocystography (X-ray of the tear duct system) can help locate the obstruction.

Treatment of a Blocked Tear Duct

The good news is that a blocked tear duct can often be treated effectively. Here are the most common approaches:

1. Conservative Management

• For Infants: In newborns, most cases resolve without intervention as the duct develops. Gentle massage of the tear duct area can help open it up.
• Antibiotics: If there’s an infection, topical or oral antibiotics may be prescribed.

2. Surgical Interventions

• Dacryocystorhinostomy (DCR): This is the gold standard for adults with persistent blockage. The surgeon creates a new pathway for tears to drain directly into the nasal cavity.
• Balloon Catheter Dilation: A tiny balloon is inserted and inflated to open up the duct.
• Probing and Stenting: A probe is used to clear the blockage, and a stent may be placed to keep the duct open.

3. Minimally Invasive Procedures

• Endoscopic surgery offers a less invasive option for creating a new drainage pathway.

Prevention and Self-Care

While you can’t always prevent a blocked tear duct, certain steps can reduce your risk:

• Practice Good Hygiene: Keep your eyes clean and avoid rubbing them.
• Treat Infections Promptly: Address eye or sinus infections early to prevent scarring.
• Protect Your Eyes: Use safety goggles during activities that could lead to injury.

Conclusion

A blocked tear duct may seem like a minor inconvenience, but it can significantly impact your quality of life if left untreated. Early diagnosis and appropriate treatment can restore normal tear drainage and prevent complications.

Whether you’re dealing with an infant’s watery eyes or a persistent issue as an adult, medical care is available to resolve the problem effectively.

References

1. American Academy of Ophthalmology. “Blocked Tear Ducts.” Accessed 2025.
2. Mayo Clinic. “Blocked Tear Ducts: Symptoms and Causes.” Accessed 2025.
3. National Eye Institute. “Tear Drainage System.” Accessed 2025.
4. Ophthalmology Journal. “Management of Nasolacrimal Duct Obstruction.” Published 2024.