Blocked tear ducts can happen at any age. They may be congenital (present at birth) or acquired. Causes for NLDO include:
To diagnose this condition, your doctor talks with you about your symptoms, examines your eyes and does a few tests. He or she will also examine the inside of your nose to determine if any structural disorders of your nasal passages are causing an obstruction. If your doctor suspects a blocked tear duct, you may have to undergo other tests to identify the location of the block.
Tests used to diagnose a blocked tear duct include:
The treatment of NLDO depends on the specific cause. You may need more than one approach to correct the problem. There are non-surgical and surgical treatment options for NLDO.
Non-surgical options includes:
Surgical options include:
A DCR is usually done under general anaesthesia or intravenous sedation. A DCR can be done externally or endoscopically. In an external dacryocystorhinostomy, the surgeon makes an incision on the side of the nose, near the lacrimal sac. After connecting the lacrimal sac to your nasal cavity and placing a silicone stent in the new passageway, the surgeon closes up the skin incision with a few stitches. With endoscopic or endonasal DCR, the procedure is done through the nasal end of the tear duct, thereby requiring no incision – and no residual scar. However, the success rates aren’t as high with the endonasal approach as with the external procedure.
Following surgery, nasal decongestant sprays and eyedrops are used to prevent infection and reduce inflammation. The first review occurs 1-2 weeks after surgery, when the skin stitches (external DCR) are removed. At the second clinic visit two or three month later, the silicone stent is removed, and no further review is necessary. However, future appointments can easily be arranged if any further ocular or lacrimal symptoms occur.