How do you know if you have a blocked tear duct, and how can you treat it?

26 July 2022

Author: Kate Green

blocked tear duct

What is a blocked tear duct?


Your tear system is what keeps your eyes hydrated and slightly wet, but not so watery that your vision becomes impaired. It is comprised of three parts – your lacrimal glands, puncta, and nasolacrimal ducts. Each of these parts has a role in ensuring that your eye remains hydrated and that fluid is able to drain and be replaced again effectively.


The lacrimal glands are found inside your upper eyelids above each eye. The tears flow from your lacrimal glands to cover the surface of each eye, before draining into the puncta. The puncta are openings on the inner corners of your upper and lower eyelids. This is where the tears flow in order to leave your eye. Your nasolacrimal ducts (also known as tear ducts) are connected to the puncta and are responsible for draining your tear fluid into your nose to leave the tear system. When your nasolacrimal ducts become blocked, fluid can’t drain effectively from the eye, leading to a range of symptoms we’ll touch on shortly.


What causes blocked tear ducts?


We’ve just outlined what technically causes a blocked tear duct, but what actually leads to a blockage in the nasolacrimal duct in the first place? There are a number of causes, beginning with a congenital blockage which is relatively common in babies. This is often because the tear duct is not fully developed, or the nasolacrimal duct is covered by a thin membrane.


Tumours along the tear drainage system or in the nose can also cause blockages. On top of this, you may find that your puncta become narrower with age, making a blockage more likely. Your puncta can also narrow as a result of infection or inflammation, particularly if this is something you regularly experience. Injury or trauma to the face is another factor that can cause blocked tear ducts. This is because tiny particles of dislodged skin cells can lead to blockages.


If old tears remain in your drainage system for too long, they can lead to the growth of bacteria, viruses and sometimes even fungi, in turn causing inflammation and infections in and around the eyes.


What are the symptoms of a blocked tear duct?


Blocked tear ducts can manifest themselves in a number of ways with a variety of symptoms occurring as a result. If you have a blocked tear duct, you might experience some of the following symptoms:

  • Excessively watery eyes
  • Swelling and pain around the eye’s inside corner
  • Red eyes
  • Blurry vision
  • Eye infections which recur
  • Crusting and discharge or pus from the eyelids
  • Itchiness in and around the eye
  • Fever


Blocked tear ducts may also occur as a side effect of cancer treatments such as radiotherapy and chemotherapy, whether you are currently receiving these treatments or have done in the past.


How can you treat a blocked tear duct?


In babies, a congenital blocked tear duct almost always improves within the first year without requiring any treatment. For adults, the most common treatment for blocked tear ducts is oral antibiotics, which work for the majority of cases. Blocked tear ducts are nearly always treatable, but the type of treatment that you’ll be recommended depends on what’s causing your blocked tear duct.


For more severe blockages, oral antibiotics might not work as well, so in these cases you could be recommended antibiotic ointment or eye drops to apply directly to the eye. If your blocked tear duct persists and recurs regularly, there are also surgical options. One of these involves probing the tear duct to poke out any blockages, while a more invasive surgery removes some bone using a laser, in order to open up the tear duct further.


When should you seek medical advice?


You should seek medical advice if you experience:

  • Unusually watery eyes for several days
  • Repeated eye infections
  • Other eye discharge like pus
  • Crusting around the eye


Thankfully, treatments are available for just about any cause or severity of tear duct infection so, if you’re diagnosed with a blocked tear duck, the prognosis is good.


What are the risk factors for developing blocked tear ducts?


As we previously touched on, your puncta narrow as a natural result of ageing, making tear duct blockages more likely. This narrowing can also occur due to eye inflammation such as uveitis, a condition whereby the blood flow to your retina is impacted, affecting your vision negatively. The inflammation naturally narrows your puncta, as do some types of glaucoma treatment eye drops.


You also should be especially aware of a potential blocked tear duct if you have previously had surgery on your eye, eyelid, nasal passage or sinuses. It is possible that you are dealing with scarring in your duct following these surgeries, increasing your risk of experiencing a blockage later in life. Other things which can increase your risk factor for suffering with blocked tear ducts include:

  • Glaucoma
  • Recurrent eye infections
  • Eye inflammation like uveitis


How can you reduce your risk?


Reducing your risk for blocked tear ducts comes hand in hand with reducing your risk of eye infections, as one leads to the other. Most of the advice around ways in which to reduce your risk of blocked tear ducts involves practicing good eye and contact lens hygiene. The best things you can do to have the biggest impact are:

  • Don’t touch your eyes without washing hands
  • Replace your eye makeup regularly
  • Don’t share eye makeup with others – helps to prevents cross contamination
  • Don’t rub your eyes too hard
  • Practice good contact lens hygiene


It’s important to keep monitoring any change to your eye health so you can act promptly when the time comes, in order to protect your vision as much as possible.

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