TEAR DUCT INFECTION OR BLOCKAGE

General Information

DEFINITION--Infection of the tear duct, sac or gland is called dacryocystitis. The germs that cause the infection can be spread to other people. Scarring, blockage or narrowing of the tear duct--usually from inherited abnormality or prior infection--is called dacryostenosis.

BODY PARTS INVOLVED--Eye; tear (nasolacrimal) gland, sac or duct.

SEX OR AGE MOST AFFECTED

• Inherited blockage of the tear duct usually appears in infants at 3 to 12 weeks.
• Infection of the tear duct or sac occurs in all ages, but it is most common in children.
• Blockage caused by infection can occur at any age following an infection.

SIGNS & SYMPTOMS--

The following symptoms may apply to either blockage or infection:

• Persistent tearing of one or both eyes.
• Drainage of mucus and pus instead of water from the tear duct. The drainage may flow spontaneously or with pressure on the area.
• Pain, redness or swelling beneath the eye suggesting infection.
• Redness and swelling of the tear duct.
• Redness of the white of the eye surrounding the tear duct.

CAUSES--

Obstruction of the tear duct resulting from the following:

• Inherited abnormality.
• Bacterial infection of the duct.
• Sinus or nasal infection, especially chronic nasal infection.
• Nasal polyps.
• Eye injury.
• Eye infection, including severe pink eye (conjunctivitis).
• Fracture of the nose or facial bones.

RISK INCREASES WITH

• Newborns and infants, especially those with a family history of blocked tear ducts.
• Recent infection, such as those listed above.

HOW TO PREVENT--Obtain prompt medical treatment for eye, nose or sinus infections.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.

APPROPRIATE HEALTH CARE

• Often requires no treatment other than massage.
• Home care after diagnosis.
• Doctor's treatment.
• Surgery to dilate and probe the tear-duct canal. In infants, this usually requires a brief general anesthesia in an out-patient surgical facility. In adults, it is often done in the doctor's office with local anesthesia. After dilation, the tear-duct system is irrigated with saline. (See Tear-Duct, Opening of in Surgery Section.)
• Complete obstruction may require a surgical opening from the eye into the nasal passage.

POSSIBLE COMPLICATIONS

• Without treatment, an obstruction may cause chronic infection.
• Without treatment, infection may spread to the cornea and other parts of the eye or permanently scar the tear duct.

PROBABLE OUTCOME--

• Infection is usually curable with antibiotics.
• Obstruction is usually curable with dilation of the duct or surgery. Allow 3 weeks for recovery.

How To Treat

GENERAL MEASURES--

• For obstruction (if surgery is not necessary): Massage the tear duct twice a day with fingertips to milk the contents.
• For infection: Relieve pain by applying warm soaks (see Soaks in Appendix).

MEDICATION--Your doctor may prescribe oral or topical antibiotics for infection.

ACTIVITY--Reduce activity during treatment for the infection. Avoid swimming and contact sports.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of a tear-duct infection or blockage.
• You have a temperature of 101F (38.3C) or more.
• Symptoms don't improve, despite treatment.
• Your vision is affected.