The Common Occurrence of Nasolacrimal Duct Obstruction in Children

Woman Eye Exam | Florida Eye Specialists

A nasolacrimal duct obstruction, or as it is more commonly known—A blocked tear duct—is very common among children. Approximately 5% of children will develop a blocked tear duct, but over 90% of them naturally resolve this issue by the time they turn 1 year old. The other small percentage of kids who are left with a blocked tear duct will require a short surgical procedure to clear and open the tear duct.

Tears drain through small openings, called puncta, located in the corners of your lower and upper eyelids. The puncta are actually connected to your nose as well via the nasolacrimal duct. When your tear duct becomes obstructed it prevents tears from draining and creates backflow made up of tears and discharge. It isn’t uncommon for a blocked tear duct to be mistaken for conjunctivitis—an even greater threat for a newborn. One way to decipher between the two is to look at color of the discharge and if the whites of the eye are red. If you find that the eye isn’t red and there is yellow discharge, there is a strong possibility your child has a blocked tear duct.

Most commonly, the cause of a blocked tear duct is due to a membrane at the end of the nose failing to open normally near the time of birth. Blocked tear ducts can also be caused by a narrow tear duct, or a tear duct fails to form. Blocked tear ducts are not a contagious ailment and naturally clear themselves out most of the time. There are occasions where medical techniques will need to be used to open the blocked tear duct.

Some Pediatricians prescribe antibiotic eye drops to protect the eye from bacteria in the discharge. Eye massages are another common method that Pediatricians will use to treat obstructions in the tear duct. While called an “eye message” the massage itself actually occurs around the inner apex of the nose, allowing for the backflow to be pushed out of the puncta preventing a buildup of bacteria.

If the puncta continues to be blocked past the age of 1, a nasolacrimal duct probing will be required. This is a quick procedure that solves 90% of the cases of children who continue having issues with tear duct blockage, the other 10% of children will need a more involved procedure in which small silicone tubes are placed in the clogged tear duct for a few months.

It is important that this issue be taken care of as quickly as possible because after the age of 2, nasolacrimal duct probing has lower success rates. If a tear duct is left blocked it will increase the chances of tear duct infections that can require hospitalization.