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Blocked tear duct: What causes it?

What causes a blocked tear duct? How do you treat it?

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Mayo Clinic ophthalmologist Dennis Robertson, M.D., and colleagues answer select questions from readers.

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Illustration of tear drainage system Tear drainage system

Blocked tear ducts occur most often in older adults — although they can occur in younger people as well. Causes of a blocked tear duct include:

  • A temporary condition in infants when there's delayed opening of the tear ducts. This problem usually resolves itself in the first month of life.
  • Age-related changes affecting the eyes and eyelids in older adults.
  • Inflammation of any of the channels that carry the tears into the nose; including infections within the nose.
  • Injury to the nose.
  • A rare side effect of certain medications.
  • Tumor.

Normally when you blink, your eyelids spread tears over the surface of your eye and push excess tears into your tear ducts, where they drain into your nose. If your tear ducts are blocked, the tears have no place to go — and they back up and spill over the lower eyelid.

Blockage of the tear ducts can occur anywhere in the tear-drainage system. Occasionally, a blocked nasolacrimal duct can lead to an infection in the lacrimal sac due to bacteria that accumulate in the stagnated tears (dacryocystitis). This may cause swelling and tenderness in the area between the inner angle of your eye and the bridge of your nose.

Treatment of blocked tear ducts may include:

  • Dilating the puncta — a simple procedure that can be done in your doctor's office
  • Flushing, or irrigating, the tear ducts — a simple procedure that's generally done at the same time your puncta are dilated
  • Antibiotics, if infection is present
  • Surgery — which can be fairly simple or more complex depending on the cause of blocked tear ducts

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Jul 6, 2008