What is Tear Duct Obstruction? Symptoms and Treatment

Tear duct obstruction occurs in about 5% of newborn babies. According to Op. Dr. Yusuf Avni Yılmaz, an Eye Diseases Specialist at Anadolu Health Center, complaints of tear duct obstruction typically begin a few weeks after birth. “Although the most common cause of tearing in babies is tear duct obstruction, there are other reasons as well. The most important of these is congenital glaucoma, or eye pressure. Congenital glaucoma is a much more serious condition compared to duct obstruction. Additionally, tumors and cysts should also be considered, along with simple congenital abnormalities that may block the duct,” he explained. We recommend considering the suggestions of Eye Diseases Specialist Op. Dr. Yusuf Avni Yılmaz...

The structures of the tear system begin to form in the 5th week of pregnancy, while the tear duct starts to develop in the 8th week of pregnancy. This formation and development continue throughout the duration of the pregnancy. Tears are produced in the tear glands, fill the sac through small ducts, and flow into the nasal cavity via the tear duct. The contraction of the eyelid muscles acts as a pump to drain the tears into the nasal cavity. Any blockage in this system results in tearing...

Tear Duct Obstruction: Congenital Glaucoma Should Also Be Evaluated During Eye Examination

Tear duct obstruction observed in newborn babies can occur anywhere in the system but is largely seen at the point where the tear duct opens into the nose. Symptoms typically begin within a few weeks after birth, with excessive tearing being the first sign. However, as the condition progresses, yellow discharge, commonly known as "eye crusting," may also accompany the tearing. Although the most common cause of tearing in babies is tear duct obstruction, there can be other causes as well. The most important of these is congenital glaucoma, or eye pressure. This must always be considered in the differential diagnosis. Congenital glaucoma is a much more serious condition compared to duct obstruction. Additionally, tumors and cysts should also be taken into account along with simple congenital abnormalities that may block the duct.

Tear Duct Obstruction: Treatment Should Be Based on the Cause of Tearing

Diagnosis begins with a careful examination. The characteristics of tearing and the presence of accompanying signs provide significant clues. If necessary, additional tests may include examining the baby under anesthesia, measuring eye pressure, measuring corneal diameter, and imaging the tear pathways. Treatment should be tailored to the cause of tearing. Since the cause is often congenital narrowing or blockage of the duct, treatment needs to be divided into two parts. Initially, non-invasive treatment is recommended, where the primary element is massaging the tear sac. The goal here is to increase the pressure within the sac through massage, thereby opening the membrane causing the blockage at the duct's opening. With appropriate massage, most cases resolve by the age of one. If tearing is accompanied by yellow discharge, it should be considered an infection, and necessary treatments should be initiated.

Tear Duct Obstruction: Treatment Options Range from Medication to Surgical Intervention

The second treatment option is the probing of the tear ducts in cases where the condition does not improve by age one despite massage or in situations where the baby is younger than one year but experiencing uncontrollable tear duct infections. This procedure is performed under general anesthesia but is a short process, requiring only a brief period of anesthesia for the baby. The procedure yields significant results.

Treatment for causes of tearing other than simple duct obstruction is entirely focused on the underlying reason. Congenital glaucoma is a serious condition that should be primarily considered. In this case, treatment options range from medication to surgical interventions. Similarly, treatments need to be directed towards the cause in cases involving tumors, cysts, or other conditions blocking the tear system.

Tear Duct Obstruction: Do Not Delay Treatment

If treatment for duct obstruction is delayed, various complications related to frequent infections may develop. Additionally, the success rate of probing decreases significantly after 12 to 15 months of age. While a simple intervention like probing can resolve the issue with early diagnosis, more extensive surgeries will be necessary after the age of one. Late diagnosis of congenital glaucoma can also lead to serious, permanent vision loss.