What Is a Blocked Tear Duct in Adults?

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A blocked tear duct (nasolacrimal duct) is a condition in which the tear drainage pathway in the eye is partially or completely blocked, leading to difficulty in draining tears from the lacrimal glands. Blocked tear ducts are common in babies, affecting six out of 10 newborns, and usually resolve on their own in these cases. In children, the tear duct may not be completely developed at birth. It may be closed or covered by a thin film, causing a partial blockage. However, adults can also have a blocked tear duct. Adults with a blocked tear duct require medical assistance. In these cases, the duct may be damaged by an infection, an injury, or a tumor.

man rubbing his eyes

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Blocked Tear Duct Symptoms in Adults

Tears normally drain from the eye through the nasolacrimal ducts, which are small tubes that stretch from the eye into the nose. If a tear duct becomes blocked or fails to open, tears cannot drain from the eye properly. The duct may then fill with fluid and become swollen, inflamed, and sometimes infected.

Symptoms of Blockage

The main symptom is increased tearing (epiphora), which causes tears to overflow onto the face or cheek. At times, the tears may appear to be thicker. The eyes may also become dry and crusty.

The symptoms of a blocked tear duct may get worse after a cold or sinus infection. They may also become more noticeable after exposure to the cold, wind, or sunlight.

Symptoms of Infections

When tear ducts are blocked, trapped bacteria in the nasolacrimal sac can lead to an infection called dacryocystitis. In severe cases, infection can spread to the eyelids. 

Symptoms of infection include:

  • Inflammation, tenderness, and redness of the inside corner of the eye or around the eye and nose
  • Recurrent eye infections
  • Eye mucus discharge
  • Crusty eyelashes
  • Blurred vision
  • Blood-tinged tears
  • Fever

It's important to reach out to your eye-care provider for diagnosis and treatment if you have signs of an infection.

Causes

In adults, blocked tear ducts may be caused by an injury to the bones or tissues around the eyes or by another disorder.

The causes of blocked tear ducts in adults include:

  • Abnormal development of the skull or face: Those with skull or facial abnormalities, like Down syndrome, are more likely to be affected by a blocked tear duct.
  • Trauma to the nose: In injuries to the nose, such as a broken nose, scar tissue can block the tear duct.
  • Nasal polyps: Polyps are growths in the lining of the nose (affecting some people who have nasal allergies) that can obstruct the tear duct system.
  • Tumors: These may press on the tear duct itself and prevent drainage.
  • Age-related changes: Changes like narrowing of the punctal openings, tiny openings in the inner eyelid, can cause blocked tear ducts.
  • Conjunctivitis: This is inflammation of the conjunctiva, the mucus membrane lining the inner surface of the eyelids and the front of the eye. In some cases, conjunctivitis may cause tearing due to the inflammation.

Diagnosis

Your eye doctor (an ophthalmologist or optometrist) will first perform a complete medical eye exam. They will also discuss your medical history and thoroughly examine your eyes to check for other possible causes of your symptoms.

To check for blockage in the tear duct, they will conduct a dye disappearance test. One drop of a special dye is placed in each eye. If there's still a significant amount of dye in your eye after five minutes of normal blinking, you may have a blocked tear duct.

In complicated cases, your doctor may order an X-ray of the tear duct area. Specifically, they will take a dacryocystogram, which involves injecting a radiographic dye into the tear canal. This contrast agent allows your doctor to visualize blockage within your tear duct.

Treatment

Treatment will vary depending on what the cause of your blocked tear duct is. If your condition was caused by a facial injury, the drainage system starts working again on its own a few months after the injury, and no additional treatment is necessary. In other cases, your doctor may recommend prescription medications or surgery.

Antibiotics

If an infection is suspected, your doctor will prescribe antibiotics. In severe cases, people with a tear duct infection may need intravenous antibiotics and observation in the hospital. Antibiotic eye ointment or eye drops may be prescribed in some cases. Chronic infections, however, can be difficult to cure without surgery to expand the tear duct's drainage channel.

Do not apply an over-the-counter antibiotic ointment not specifically formulated for use in the eye to the eye or area around it. These medications are not made for use in the eye and could have irritating ingredients.

Dilation, Probing, and Irrigation

For adults who have a partially blocked duct or a partial narrowing of the puncta, this technique may be used. An instrument is used to enlarge the punctal openings, and a narrow probe is guided through the puncta, into the tear drainage system, and then through the nasal opening before being removed. The tear drainage system is flushed with a saline solution to clear out any residual blockage.

Balloon Catheter Dilation

A balloon catheter dilation procedure opens tear drainage passages that are narrowed or blocked by scarring or inflammation. Your doctor will pass a thin wirelike probe of about 2–3 mm (millimeters) wide with an inflated balloon on the tip through the blocked tear duct and into the nasal cavity. Then they will inflate and deflate the tiny balloon with a sterile saline solution several times to open the blockage and expand the tear duct. This is done under general anesthesia.

Stenting

In this procedure, also called tear duct intubation, tiny tubes are used to open narrow passageways within the tear drainage system. Your doctor guides a metal mesh tube (a stent) through one or both puncta in the corner of your eye, through the tear drainage system, and into the back of the nose. A tiny loop of tubing is left in the tear duct. While it may be visible, it's usually not bothersome. These tubes are generally left in for three to four months, and then removed. This approach also requires general anesthesia.

Surgery

If the above treatment options are not sufficient to open your blocked tear duct, your doctor will recommend surgery, usually dacryocystorhinostomy. This procedure creates a new route for tears to drain out through your nose. This new section bypasses the nasolacrimal duct, which typically is where the blockage occurs. Stents usually are placed in the new route and left there while it heals. They are removed three or four months after the surgery. The steps in this procedure may vary for your particular tear duct blockage problem.

Depending on the type of blockage, your surgeon may recommend creating an entirely new route from the puncta to your nose, bypassing the tear drainage system altogether. This reconstruction of the entire tear drainage system is called conjunctivodacryocystorhinostomy.

If a tumor is causing the tear duct blockage, surgery will be performed to remove it. Or, your doctor may suggest using other methods, such as chemotherapy or radiation therapy, to shrink it. 

Postoperative Care

To prevent postoperative infection and inflammation, you will need to use a nasal decongestant spray and eye drops. After about three to six months, your ophthalmologist will remove any stents that were put in place to keep the new channel open while healing.

A Word From Verywell

Blocked tear ducts can be uncomfortable and irritating, but they can be managed and repaired depending on the severity. Having a blocked tear duct is a common problem in children, but it can occur in adults too. Some causes of a blocked tear duct will resolve on their own, but others require antibiotics and even surgical treatments. The earlier you get a blocked tear duct treated, the better your outcome and quality of life will be. If you have watery eyes and other symptoms of a blocked tear duct, talk to your eye-care professional about diagnosis and treatment.

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6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Michigan Medicine. Blocked tear ducts. Updated May 27, 2020.

  2. American Academy of Ophthalmology. What is a blocked tear duct? Published March 1, 2015.

  3. MedlinePlus. Blocked tear duct. Updated February 26, 2021.

  4. American Academy of Ophthalmology. Blocked tear duct symptoms. Published October 14, 2015.

  5. American Academy of Ophthalmology. Blocked tear duct causes. Published October 14, 2015.

  6. American Academy of Ophthalmology. Blocked tear duct treatment. Published October 14, 2015.

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