Blockage of the Tear Ducts

The most common cause of watery eyes is blockages in the tear collection system. These blockages usually occur at the lower end of the tear duct and the reason is unknown. Tear duct blockages, which are mostly seen in middle-aged and older patients, can also occur in newborns due to a thin membrane. Other causes of tear duct blockages are infections, tumors and trauma.

Children may be born with a blockage in the tear drainage pathways. Watery eyes and ocular discharge in one or both eyes of the baby can be a sign of congenital blockage of the tear ducts. It may be more common in preterm infants, mostly in male and cesarean ones.

Congenital ones are caused by the fact that during the development of the baby in the womb, the tear ducts have not yet completed their formation. Usually the problem is that the baby is born without perforating the membrane where the lacrimal sac opens to the nose. In this case, tears cannot drain into the nose and blockages can cause watery eyes and ocular discharge.

What are the symptoms of tear duct blockages?

Symptoms of tear duct blockages include watering, ocular discharge, infection, skin irritation and swelling in the tear sac area. Patients also complain of having to constantly wipe their eyes

What is the treatment of tear duct blockage (Daktryostenosis) in infants?

This condition in babies is usually temporary. There is a high probability of improvement with proper drops and massage. If the canal blockage does not improve until the age of 1 year, the blockage at the lower end of the canal is opened by entering the upper end of the tear duct with an instrument called probe under general anesthesia. The success rate of this intervention called probing is around 95%.

• Patients who do not improve in probe application can be reapplied after 3 months.
• If watering does not improve, Writleng or similar silicone tube implantations are performed between the ages of 1.5-6.
• If there is no success after probe or silicone tube, surgical correction called Dacryocystorhinostomy is required at the age of 6.

Dacryocystorhinostomy operation

If the cause of watery eyes is found to be a blocked tear duct, the treatment is usually surgical. The aim of the treatment is to create a new pathway between the lacrimal sac and the nasal cavity. For this purpose, dacryocystorhinostomy surgery is performed. In some cases where there is a high probability of blockage of the newly opened canal, a silicone tube is temporarily inserted into this canal.

Three types of surgery are possible.

1. In operations performed through a skin incision, a skin incision is performed between the nose and the eye. By entering from here, a new pathway is opened between the nose and the lacrimal sac. This surgery method has the highest chance of success, but it may cause cosmetic concerns in patients because it leaves scars on the skin.

2. In surgeries performed through the nose with the help of an endoscope, a pathway is opened through the nose into the tear sac. This surgery, which is more preferred for cosmetic reasons, has a slightly lower chance of success compared to open surgery.

3. In the method that has been applied in recent years, surgery is performed with the help of a laser by entering through the canaliculi, the opening of the tear duct on the eye side (Transcanalicular laser dacryocystorhinostomy). In this method, under local or general anesthesia, the opening of the tear duct is widened, and the laser probe is inserted into the duct. The probe is moved towards the nose and placed against the lateral nasal wall. At this point, the laser is activated, and a new opening is created between the canal and the nose. The procedure is continuously monitored with an endoscope through the nose and the tissues are destroyed by burning until the location and size of the opening are adjusted as desired. Then a silicone tube is inserted into the canal and the operation is finalized.