Blocked tear ducts (NLDO)

A blocked tear duct is a fairly common. Tear ducts are like tiny tubes that your tears pass through. They are part of the drainage system that goes from your eyes to your throat. A blocked tear duct happens when your nasal passageways in your nose become blocked and cannot properly drain tear liquid from your eyes. This can also be called nasolacrimal duct obstruction (NLDO).

Having blocked tear ducts does not mean that you cannot make tears. It means that the drainage system is blocked and the tears cannot drain away down your nose and throat.

What are the symptoms?

Symptoms include:

• watery eyes (also known as Epiphora) – either constantly or intermittent periods even if your child is not upset or crying
• sticky discharge around the eye which may be worse in the mornings

This stickiness is caused by stagnant tears sitting in the tear sac. The warmth and moisture creates germs and causes the eye to become sticky.

Although this is unpleasant, your child will rarely need an antibiotic for the stickiness.

What can I do?

For around 90 percent of children with blocked tear ducts, it will suddenly clear by itself around the age of 1 year old.

You can help at home by massaging and cleaning the eye regularly.

This is done by applying gentle pressure under the inner corner of the lower lid. Stroke downwards firmly to put a little pressure on the drainage system so it might clear itself.

Repeating this 10 times, 2 times a day will help ease the symptoms. Our nurses will be happy to demonstrate this technique.

Always clean the eye with a ball of cotton wool or a clean make up pad and clean water. Sweep across the eye and discard the cotton wool and repeat the process until the eye is clean.

What if this does not work?

Around 10 percent of children over the age of 18 months will need surgery to fix blocked tear ducts called ‘tear probing’. This will be done by an eye doctor.

It is done under general anaesthetic and involves passing a narrow probe through the tear duct to unblock the obstruction and also diagnose the location of the blockage. The tear duct is then flushed through with saline to clear the system out.

Your child will be able to go home on the same day following the procedure.

After the probing, your child may have blood stained tears and a runny nose for a few days, this is to be expected and should settle down. You will need to put eye drops in your child’s eye as part of their post-operative care. The eye drops will help prevent infection and inflammation. The drops will usually need to be put in 3 times a day for 1 month and the eye nurse will be happy to demonstrate how to do this.

You may not see the effects of the probing immediately and should wait up to 2 weeks before you expect see the benefits.

Your child will be seen again either by the doctor or nurse to monitor the progress of the procedure.

Sometimes the procedure does not work and your child may need a further probing. If this is the case, it will be discussed at your follow up appointment.