Clogged tear duct

Introduction

The tear duct opens into two small openings on the inner edge of the upper and lower eyelids of the eyes and drains off tear fluid that exceeds the amount needed to moisten the eyes normally. This tear fluid then drains off into the nasal cavity, which is why one literally howls “snot and water”, because when crying, the tear fluid then drains off from the nose. The blockage of the tear duct occurs more often in women than in men and those affected complain about constantly watery eyes.

The natural drainage system of overproduced tear fluid is laid over the nose, so that the tears then find another way and flow off via the cheek and face, visible to outsiders. This leads to a heavy strain on the affected person, after all, it looks to other people as if they are crying very often. Some of the liquid runs into the lacrimal sac at the beginning of the tear duct, but cannot drain further towards the nose, as this way is blocked.

So the liquid remains in the lacrimal sac for a longer period of time, where it would normally only be for a short time, and infections often occur. This usually causes painful swelling of the inner corner of the eye and/or inflamed discharge from the eyes. In newborns up to the first year of life, the blockage of the tear duct can be opened by itself by regular light massage of the points.

In cases where the lacrimal duct is not opened, the adult can open the lacrimal duct by surgical intervention. In newborn babies, until the first year of life, the blockage in the lacrimal duct can be opened by regular massage from itself to the nose, so that excessive tear fluid can flow off regularly. Medication can be used if the tear duct is blocked.

This is especially the case when an infection is the trigger for the symptoms. Especially in adults, an eye infection can temporarily obstruct the tear duct and thus lead to a blockage. Antibiotic eye drops containing antibiotics can be used, especially if there is a bacterial inflammation.

Other eye drops that relieve the irritation of the eye are also helpful. If medication and the massage of the tear ducts cannot eliminate the symptoms, surgical therapy may also be necessary. If conservative therapeutic measures do not bring the desired success in the case of a lacrimal duct obstruction, surgery is necessary in most cases.

Various surgical methods can be used to create a functioning drainage channel between the lacrimal duct and the lower nasal concha, so that the lacrimal congestion can be removed. Which method is ultimately used depends on the cause of the lacrimal duct obstruction, on the one hand, and on the condition or age of the patient and the experience of the treating physician, on the other hand. For children, a so-called tear duct intubation under general anesthesia is usually sufficient.

A thin silicone tube is inserted and placed into the tear ducts from the outside, which keeps them permanently open and prevents them from becoming blocked, collapsing or stuck together again. If the trigger in newborns is the tear duct orifice closed by a mucosal fold, this can also be probed and opened under general anesthesia with a catheter. Another surgical method, but more commonly used in adults, is endonasal lacrimal duct surgery, in which a piece of the bone lamella between the lacrimal sac and nasal cavity is removed via the nose and a drainage-free opening of the lacrimal ducts is created.

This procedure is also performed under general anesthesia. A somewhat less invasive surgical procedure is the endoscopic removal of the outflow disorder, whereby the surgeon first inserts an instrument equipped with a small camera into the lacrimal ducts in order to assess the conditions there. In a subsequent step, the causes of the tear duct can then be eliminated using additional instruments: here too, a silicone tube or a plastic tube can be inserted, but in addition, dilatation and opening of tear duct structures can be performed using a balloon expanding in the duct, a micro-drill or laser.After an already expired inflammation of the lacrimal gland, surgery access from the outside is usually preferred, whereby the skin and the lacrimal sac at the inner corner of the eye are opened under general anesthesia and an artificial connection to the nasal concha is established.

In most cases, the lacrimal duct stenosis remains permanently corrected after each of the listed surgical methods and the symptoms do not appear. In a few cases, however, it can also lead to a re-closure. After the operation, care should be taken to avoid “blowing your nose” for several days and to avoid heavy physical exertion.

The treatment of the blocked lacrimal duct is surgical. During the operation, a free transition is created between the lacrimal sac and the nasal cavity. In some cases, a silicone tube is inserted into the lacrimal duct to prevent the tear duct from being blocked again after the operation.

After two months, the procedure has healed sufficiently for the silicone tube to be removed again. The success rate of this surgical treatment of the blocked lacrimal duct is very high. The tear duct plays an important role in the regulation of fluid in the eye.

If it is blocked, the eye can tear or even burn and redden. However, there is no need to take medication directly against the blocked lacrimal duct. Rather, there are some home remedies that can also relieve the symptoms.

Babies and small children in particular occasionally experience a blockage of the tear ducts in one or both eyes. Regular massage of the affected tear ducts can help here. Adults also suffer from occasional symptoms.

Here too, the tear ducts can be massaged, but the therapy is not always as successful as with babies. Warm compresses can help against the blocked tear duct. These can relieve the symptoms of irritated eyes.

It is best to take a cloth and put it briefly in warm (not too hot!) water. Then place the cloth over your eyes (or only over one affected side) for about twenty minutes.

The warmth of the compress can stimulate the blood circulation in the affected area and, if necessary, also slightly dilate the tear duct. Eye rinsing can also help to relieve a blocked tear duct. According to grandma’s home recipes, such rinses are particularly effective if they are carried out with lukewarm water or lukewarm black tea.

In addition, the nose can also be rinsed with a saline solution (Emser salt, NaCl 0.9%). The lacrimal duct ends in the nose, so that the cause of the constipation can also be located there. If necessary, this can be eliminated by rinsing the nose.

Other methods of warming the eye can also be helpful. In this case, however, attention should be paid to a moist warmth such as a warm eye shower. One can also try to solve the problem with the help of Schüssler salts.

Especially the salts number 9 (sodium phosphoricum) and number 12 (calcium sulfuricum) are suitable for this purpose. Also before taking homeopathic remedies you should consult a pharmacist, alternative practitioner or doctor. If the blockage of the tear duct does not subside, a doctor should be consulted, who will treat the blockage with conventional medicine.

Initially, homeopathic remedies can be used in addition to home remedies for the blocked tear duct to relieve the symptoms. For example, eyebright (Euphrasia offcinalis) can be used in the form of eye drops. Another homeopathic possibility is the use of Silicea D12 globules against the blocked tear duct.

Obstructions of the lacrimal duct result from several different causes. On the one hand, the lacrimal duct may already be blocked at birth. In this case, malformations of the lacrimal duct are usually the cause.

The lacrimal duct can be underdeveloped at birth or deviate from the norm. But also structural abnormalities of the face or skull in newborns can predispose blocked lacrimal ducts. In the course of life, however, obstructed lacrimal ducts are usually caused by other triggers.

Frequently, infections or inflammations of the lacrimal ducts, glands, eyes or even the nose are responsible. Similarly, a blockage in the lacrimal duct can be followed by inflammation and make the symptoms worse. This can also happen through injuries in the facial area.For example, the consequence of a trauma in the area of the eyes, as it happens with a punch in the face.

In addition, the tear duct can be blocked by small stones or tumors. Finally, blockages become more frequent, especially in old age, as the tear ducts become narrower during the physiological aging process. A blockage or obstruction of the lacrimal duct can have various causes (malformations, injuries, infections) and usually results in inflammation of the lacrimal sac (dacryocystitis).

Newborns and infants are predisposed to this disease, as the lacrimal ducts are not fully developed after birth in many cases. This is due to the fact that the ductal system in embryonic/fetal development begins and is completed relatively late (after 5-6 months of development) and that the lacrimal ducts often do not have a functioning opening to the nose after birth (congenital stenosis). This phenomenon is observed in approx.

6% of newborns and is caused by the fact that the opening of the lacrimal duct into the lower nasal concha is closed by a fold of mucous membrane (Hasner’s valve). This functional closure is physiological in the pre-natal phase in the mother’s abdomen, whereby the valve usually opens spontaneously with the onset of birth. However, if this opening does not occur, the consequence is a disturbed outflow of tear fluid through the nose, so that the tear fluid instead drains over the edge of the eyelid or face.

Statistically speaking, a persistence of the mucosal fold after birth is frequently observed in premature male births and cesarean section babies. Due to the accumulation of tear fluid, there is also an increased risk of bacteria settling and resulting inflammation of the tear gland. Statistically speaking, children born with a blocked lacrimal duct are usually male, premature babies and/or born by caesarean section.

Typical symptoms are also here glued, constantly watering eyes. The reason for the obstruction of the lacrimal duct in newborns is that the formation of the lacrimal duct during development in the mother’s abdomen ends at a very late stage, relatively shortly before birth. If this stage of development has not yet been completed and the baby is already born, there is still a thin membrane where in fully developed babies there is a hole between the lacrimal sac and the nose.

In the affected babies, the tear fluid cannot flow out through the nasopharynx, stagnates in the lacrimal sac and runs down the face. Usually the tear duct opens up towards the nose after a while. This process can be supported by suitable eye drops prescribed by the ophthalmologist, as well as by massaging the inner corners of the eyes and the transition to the nose from the outside.

If the obstruction of the lacrimal duct has not improved by the 12th-18th month of the child’s life, a catheter is inserted under general anesthesia from the upper opening of the lacrimal duct, and the obstruction is opened to the nasal cavity with a tip. This procedure takes about 3 minutes and is a very reliably successful procedure with 95% success. After birth, babies suffer particularly frequently from blockages of the tear ducts.

The composition of the amniotic fluid can play a role here. In addition, babies are covered with a so-called cheese smear immediately after birth. This is a tough paste that is formed by the body to protect the baby immediately before and during birth.

If some of the cheese goo gets into the eye, it can temporarily block the tear duct. Occasionally, the tear ducts in babies are also not yet fully open. Small membranes (very thin layers of skin) can remain in the tear duct, which only become loose over time.

A regular massage of the tear ducts can remove stuck remnants of amniotic fluid or cheese smear and thus alleviate the baby’s discomfort. The massage should be performed several times a day. After a few days to weeks, the symptoms usually improve.