Nasolacrimal Duct Obstruction

When you have a blocked tear duct, your tears can’t drain normally, leaving you with a watery, irritated eye. The condition is caused by a partial or complete obstruction in the tear drainage system. This means your eyes may be excessively watering, not because you are producing too many tears, but because you are not able to drain the tears you do make away from your eyes.

A blocked tear duct is common in newborns. The condition usually gets better without any treatment during the first year of life. If your child has a blocked tear duct, you can expect your pediatrician to refer your child to Dr. Silbert around 1 year old.

Blocked tear ducts are also common in adults and can be very annoying for the patient. Fortunately, a blocked tear duct is almost always correctable. Treatment and treatment success depends on the cause of the blockage and the age of the affected person,

You should see your doctor if you tear constantly for several days or if your eye is repeatedly or continually infected. Left untreated, this can develop into a more severe infection called cellulitis which sometimes requires hospitalization for treatment.

How the tear drainage system works

The lacrimal glands produce most of your tears. These glands are located inside the upper lids above each eye. Normally, tears flow from the lacrimal glands over the surface of your eye. Tears drain into the puncta, located in the inside corners of your upper and lower eyelids. Your eyelids have small canals (canaliculi) that move tears to a sac where the lids are attached to the side of the nose (lacrimal sac). From there, tears travel down a duct (the nasolacrimal duct) draining into your nose. Once in the nose, tears are reabsorbed.

Symptoms of a blocked tear duct

  • Excessive tearing
  • Redness of the eye (white area)
  • Recurrent eye infection or inflammation (pink eye)
  • Painful swelling near the inside corner of the eye
  • Crusting of the eyelids
  • Discharge from the lids and surface of the eye
  • Blurred vision

Causes of a blocked tear duct

  1. Congenital blockage. Many infants are born with a blocked tear duct. The tear drainage system may not be fully developed or there may be a duct abnormality. Often a thin tissue membrane remains over the opening that empties into the nose (nasolacrimal duct). Once a child is over a year old, and if the condition does not clear up on its own, this can be surgically corrected.
  2. Age-related changes. As you age, the tiny openings that drain tears (puncta) may get narrower, causing a blockage.
  3. Infection or inflammation. Chronic infection or inflammation of your eyes, tear drainage system, or nose can cause your tear ducts to become blocked.
  4. Injury or trauma. An injury to your face can cause bone damage or scarring near the drainage system, disrupting the normal flow of tears through the ducts. Even small particles of dirt or loose skin cells lodged in the duct can cause blockage.
  5. A tumor in the nose or anywhere along the tear drainage system can cause blockage.
  6. Rarely, long-term use of certain medications, such as eyedrops used to treat glaucoma, can cause a blocked tear duct.
  7. Cancer treatments. A blocked tear duct is a possible side effect of chemotherapy medication and radiation treatment for cancer.


To reduce your risk of developing a blocked tear duct later in life, get prompt treatment of eye inflammation or infections. Follow these tips to avoid eye infections in the first place:

  • Wash your hands thoroughly and often.
  • Try not to rub your eyes.
  • Replace your eyeliner and mascara regularly. Never share these cosmetics with others.
  • If you wear contact lenses, keep them clean according to recommendations provided by the manufacturer and your eye care specialist.

Why Dr. Silbert

David Silbert, MD, FAAP is one of the leading surgeons in the country for the treatment of Nasolacrimal Duct Obstruction. He is one of the only surgeons performing endoscopic surgical treatments to improve obstruction symptoms. By inserting balloons or stents endoscopically, the procedure is less invasive, safer for the patient, and has no scarring of the face.