Lacrimal Duct Stenosis
(Blocked Tear Duct; Nasolacrimal Duct Obstruction; Lacrimal Duct Obstruction; Dacryostenosis)
Lacrimal duct stenosis is a narrowing of a tear duct (lacrimal duct). It can happen in children and adults. This fact sheet will focus on lacrimal duct stenosis in babies.
The lacrimal duct (in blue) drains tears from the eye down into the nose. The opening of the ducts are near the inner corner of the eye.
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Lacrimal duct stenosis happens in some babies when the tear duct does not form as it should. A thin membrane may cover the opening of the duct into the nose.
Things that may raise the risk of lacrimal stenosis are:
- Having a face or skull that does not form as it should
- Down syndrome
A baby with lacrimal duct stenosis may have:
- A lot of tearing
- Eye redness, warmth, and swelling
- Eye irritation
- Mucous coming from the eye
- Crusting on the eyelid
The doctor will ask about the baby’s symptoms and health history. An eye exam will be done. A doctor who treats eye issues may need to check the baby.
The tear duct will be checked for blockages. This can be done with a dye disappearance test. This can confirm the diagnosis of lacrimal duct stenosis.
The goal of treating lacrimal duct stenosis is to open the tear duct. This problem often goes away in the first year of life. If it does not the doctor may advise:
- Massage—The doctor may gently push on the area where the tear duct runs out of the eye, between the baby’s eye and nose. This helps push tears through the duct and open the membrane. This will also need to be done at home until the tear duct has opened.
- Probing—A tiny probe may be placed into the duct to open it. It may also be dilated with a balloon or stented to keep it open.
- Surgery—Babies who are not helped by these methods may need surgery. A tiny, flexible instrument will be placed into the tear duct. The doctor may then flush fluid through it. A laser may be used to cut away any blockage.
Lacrimal duct stenosis cannot be prevented.
- Blocked tear duct (dacryostenosis). Boston Children's Hospital website. Available at: https://www.childrenshospital.org/conditions/blocked-tear-duct-dacryostenosis.
- Nasolacrimal duct obstruction. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/nasolacrimal-duct-obstruction-15.
- Surgery for tear duct blockage. Kid's Health—Nemours Foundation website. Available at: https://www.kidshealth.org/en/parents/tear-duct-obstruct-surgery.html.
- James Cornell, MD
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