Blocked tear duct (nasolacrimal duct obstruction)

What it is

Tears normally drain through tiny openings in the eyelids into a duct that opens inside the nose. If this duct is blocked or narrow, tears overflow onto the cheek and the eye may become sticky or repeatedly infected.

Common symptoms

Symptoms are usually persistent watering rather than sudden vision loss.

• A watery eye, often with tears running down the cheek
• Sticky discharge or crusting, especially on waking
• Recurrent redness or infection around the eye
• In babies, symptoms often start in the first weeks of life

Causes

In babies the duct is often not fully open at birth. In adults blockage can follow infection, injury, sinus problems, age-related narrowing or, rarely, a tumour, so persistent new watering in one eye in an adult should be assessed.

Treatment

In babies, gentle massage and time help many cases resolve by age one. If not, a probing procedure may be needed. Adults with persistent blockage or repeated infections may need probing, stenting or surgery to restore drainage.