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Blocked Tear Duct

Overview

Partial or complete obstruction of the Nasolacrimal duct (tract through which tears flow from eye to nose) is the most common cause of chronic or recurrent eye infection of infants


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Causes

Persistence of a perforated membrane along the nasolacrimal duct blocks tear drainage and predisposes to secondary infection of retained tears.

In adults, the duct may be damaged by infection, trauma or tumour.


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Signs & Symptoms
  • Due to tear drainage block, tears pool in the conjunctival cul-de-sac and then spill over the eyelid margins, flowing on to the cheek (epiphora).
  • At night or during sleep, spillage of infected material leads to accumulation of crusted exudate along the lid margins.
  • The conjunctiva appears normal or only minimally inflamed.

Digital compression of the lacrimal sac region usually elicits reflux of mucopurulent discharge. When reflux cannot be elicited, delayed clearance of 5% fluorescein dye instilled on to the eye confirms the diagnosis of a blocked tear duct. 

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Prevention

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Treatments
Conservative Treatment Modern Medicine

For the tear duct blockage in infants, topical antibiotics with digital massage of the lacrimal sac are the initial treatments of choice and these would generally treat the blockage. 95% of tear duct blockage that is present at birth (congenital) often resolves by itself by the time the child is 6 months old. If it does not clear on its own beyond this age, then lacrimal duct probing under local anaesthesia is the treatment of choice.


Surgery Modern Medicine

The management blocked tear duct in adults is the treatment of the underlying cause. If the medical treatment does not work, then surgery for the reconstruction of the nasolacrimal duct is the chosen treatment.

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