What is Nasolacrimal Duct Obstruction

Nasolacrimal duct obstruction is a blockage in the system that drains tears from the eyes.

This system includes small openings at the inner corner of each eye and tubes that carry tears into the nose (nasolacrimal duct). This condition causes tears to well up and overflow.

What are the causes?

This condition may be caused by:

• A thin layer of tissue that remains over the nasolacrimal duct (congenital blockage). This is the most common cause.
• A nasolacrimal duct that is too narrow.
• An infection.

What increases the risk?

This condition is more likely to develop in children who are born prematurely.

What are the signs or symptoms?

Symptoms of this condition include:

• Constant welling up of tears.
• Tears when not crying.
• More tears than normal when crying.
• Tears that run over the edge of the lower lid and down the cheek.
• Redness and swelling of the eyelids.
• Eye pain and irritation.
• Yellowish-green mucus in the eye.
• Crusts over the eyelids or eyelashes, especially when waking.

How is this diagnosed?

This condition may be diagnosed based on:

• Your child’s symptoms.
• A physical exam.
• Tear drainage test.

Your child may need to see a children’s eye care specialist (pediatric ophthalmologist).

How is this treated?

Treatment usually is not needed for this condition. In most cases, the condition clears up on its own by the time the child is 1 year old. If treatment is needed, it may involve:

• Antibiotic ointment or eye drops.
• Massaging the tear ducts.
• Surgery. This may be done to clear the blockage if home treatments do not work or if there are complications.

Follow these instructions at home:

Medicines

• Give over-the-counter and prescription medicines only as told by your child’s health care provider.
• If your child was prescribed an antibiotic medicine, give it to him or her as told by the health care provider. Do not stop giving the antibiotic even if your child starts to feel better.
• Follow instructions from your child’s health care provider for using ointment or eye drops.

General instructions

• Massage your child’s tear duct, if directed by the child’s health care provider. To do this:
  • Wash your hands.
  • Position your child on his or her back.
  • Gently press the tip of your index finger on the bump on the inside corner of the eye.
  • Gently move your finger down toward your child’s nose.
• Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

• Your child has a fever.
• Your child’s eye becomes redder.
• Pus comes from your child’s eye.
• You see a blue bump in the corner of your child’s eye.

Get help right away if your child:

• Reports new pain, redness, or swelling along his or her inner lower eyelid.
• Has swelling in the eye that gets worse.
• Has pain that gets worse.
• Is more fussy and irritable than usual.
• Is not eating well.
• Urinates less often than normal.
• Is younger than 3 months and has a temperature of 100°F (38°C) or higher.
• Has symptoms of infection, such as:
  • Muscle aches.
  • Chills.
  • A feeling of being ill.
  • Decreased activity.

Summary

• A nasolacrimal duct obstruction is a blockage in the system that drains tears from the eyes.
• The most common cause of this condition is a thin layer of tissue that remains over the nasolacrimal duct (congenital blockage).
• Symptoms of this condition include constant tearing, redness and swelling of the eyelids, and eye pain and irritation.
• Treatment usually is not needed. In most cases, the condition clears up on its own by the time the child is 1 year old.