Tear duct blockage: how to treat?

The tear duct ensures that the fluid produced in the eye is drained. This tube runs from the corner of the eye on the inside of the eye to the nasal cavity. If this tube becomes blocked, it can lead to unpleasant complaints, such as a watery eye or swelling under the eye. The cause of a blocked tear duct can be congenital, but it can also be caused by inflammation, for example. In some cases, surgery is necessary to make the tear duct function again. What solutions are there for a tear duct blockage?

The tear duct

The tear duct forms the connection between the tip of the eye on the nasal side and the nasal cavity. The eye produces tear fluid through the tear gland to remove dirt and keep the eye supple. This fluid is normally mainly drained through the tear ducts on the lower eyelid and then enters the tear sac via the tear ducts, after which it is drained to the nasal mucosa. Therefore, if you cry, you will become snotty.

Blockage

If this tube becomes blocked or severely narrows the tear points, complaints such as watery eyes or swelling under the eye may occur. The blockage can be caused by inflammation, for example, but it can also be congenital. If it occurs in adults, it is usually an infection. The excess of eye fluid can no longer be drained in the normal manner and will leave the eye in the form of tears. It is also possible that the tear points no longer fit properly against the eye, so that the fluid no longer enters the tear ducts. The eye specialist will have to intervene to make the tear duct accessible again.

Need an intervention?

The ophthalmologist will determine whether a watery eye requires surgery. Tear duct blockage can have various causes. Therefore, the type of intervention depends on the cause. In some cases, a minor procedure under local anesthesia is necessary, but a larger procedure in which the patient must be anesthetized may also be an option. There are also people who have tear complaints, without a cause being found.

A bypass

During this operation, which takes place under anesthesia, an incision is made in the skin from the nose to the corner of the eye. An opening is then made in the bone between the tear sac and the nose. Then the mucous membranes of the tear sac and the nose are connected, creating a kind of bypass. The tears can flow through this created connection to the nose.

Angioplasty

If the tear duct is not completely blocked, it can be stretched with an angioplasty catheter. The catheter is so thin that it can be inserted through the tear duct through the eyelid. A balloon is inflated with a rod about 1 millimeter thick. This treatment method is still relatively new, so long-term results cannot yet be indicated. It takes place under local anesthesia.

A lacrimal duct prosthesis

In some cases, the only option to remedy this is to have a tear duct prosthesis placed. A small glass tube is placed between the eye point and the nose. The tube is approximately 15 millimeters long and 3 millimeters thick. This solution usually works fine, as long as the denture stays in place. Just after placement, the prosthesis has a tendency to shift. Almost always after placement, a minor operation will be required within the first year to put the prosthesis back in the right place.

Problems at the tear point

When the tear duct becomes blocked, there are usually multiple blockages present in the tear ducts. Abnormalities at the tear point (usually near the lower eyelid) can be corrected with a minor procedure under local anesthesia. If the tear point no longer fits properly against the eye, minor surgery can also be performed under local anesthesia. This restores the position of the tear point. This way a sagging eyelid can be corrected.

Lacrimal pump disorder

A disturbance in the function of the tear pump can also occur. This pump is driven by the blinking of the eyes. It ensures that the tear fluid is pumped into the tear duct. Functioning can be disrupted by, for example, an eyelid that is too sagging, scar tissue or damage to the muscles in the eyelid. If there is a paralyzed facial nerve, the watery eye can only be remedied by a tear duct prosthesis.

Pseudo-tears

This is a special abnormality in which the eye tears because it is actually too dry. Normally, tears adhere to the cornea of the eyeball, causing as little moisture as possible to evaporate. If something goes wrong in this process, the cornea can become dry. When the cornea dries out, the nerves send a message to the brain, prompting the lacrimal gland to produce more fluid. Overproduction may occur and the quality of the tear fluid is poor. Contrary to what you might expect, artificial tears must be used to reduce tear symptoms.

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