Tear Duct Obstruction

What is tear duct obstruction?

Each eye has a tear gland that is continually making tears, even when we are not crying, and a tear duct drains tears out of the eyes and into the nose (This is why we get a runny nose when we cry.) Some children are born with a blockage at the bottom of the tear duct. When we examine these children, we see a thin rim of water in the eye, and tears running down their cheek even when they are not crying. Because the tears do not flush properly, these children may get recurrent infections with yellow or green discharge in the corner of the eye.

Tear duct obstruction is a common problem in infants and frequently resolve on their own in the first five or six months of life. If a child’s tear ducts do not clear up on their own by seven or eight months of age, typically we would clear the blockage to prevent future damage.

How is tear duct obstruction treated?

Probing and Irrigation

We treat blocked tear ducts with a simple procedure called a probing and irrigation of the tear duct system. A fine probe breaks through the obstruction, followed by irrigation to flush out discharge. This is an outpatient procedure performed in the hospital, under light anesthesia.

The success rate of a tear duct probe is over 90 percent, but some children will require a second tear duct procedure.

Monoka Tubes

Monoka tubes are a highly effective method to treat young children who continue to tear following a nasolacrimal duct probe and irrigation, and in older children who have had no previous tear duct procedures. The success rate of Monoka tube placement is approximately 90%.

The Monoka tube placement is performed under general anesthesia and takes approximately 30 minutes. A probe is used to open the clogged area in the tear duct, then a thin tube is placed through the opening. The tube will remain in place for approximately 4 months, allowing the duct to remain open and not seal shut. There is no discomfort from this procedure, and the children will quickly resume their normal activities. The Monoka tube is easily removed at a brief office visit (no anesthesia required!).

Lacricath Balloon Dilation Procedure

The lacricath balloon dilation procedure is used to treat tear duct obstructions that do not clear with probing and irrigation. We also use this treatment in older children with tear duct blockage. During this procedure, a balloon probe is used to clear the obstruction. Near the end of the procedure, fluid is irrigated through the tear duct. This shows us that the tear duct is draining properly.

Lacricath requires general anesthesia and takes approximately 30 minutes to perform. Your child should see their primary care doctor up to 2 days prior to the procedure to ensure they are healthy enough to tolerate general anesthesia. Your child should be able to go home within a few hours after the procedure. There are no bandages and there is no pain. Your child may resume regular physical activity following the procedure.

Eye drops will be prescribed for use for three days before the procedure and for 5 days after the procedure. An information sheet will be given to you at the hospital with instructions on the care your child will need following the surgery.