Nasolacrimal Duct Obstruction (blocked tear duct / NLDO)

 

What Is Nasolacrimal Duct Obstruction?

The nasolacrimal duct is a tube that drains away excess tears. Tears enter the nasolacrimal duct via a small hole in both the upper and lower eyelids. Tears flow in the nasolacrimal duct through the bones of the nose and exit to drain in the back of the throat. If the nasolacrimal duct is narrow or blocked, it may cause excess tearing, eye discharge, and increased risk of infection.


It is very common for newborns to have a blocked tear duct. Most of the time (about 90% of the time), nasolacrimal duct obstruction resolves without treatment. If does not resolved by age 10 months, then spontaneous resolution is less likely and surgery is often recommended.

 

What If The Eye Tears Only Occasionally?

Some children experience occasional tearing that may come and go for days or weeks at a time. This type of tearing is often worse when the child suffers from allergies or an upper respiratory infection. It is often caused by a small or narrow Nasolacrimal Duct that is not totally blocked. Many times, tearing due to narrow nasolacrimal duct improves as the child mature. Allergy eye drops are sometimes helpful to reduce these tearing episodes.

 

About Surgery For Nasolacrimal Duct Obstruction

Nasolacrimal duct probe and irrigation surgery (with or without placement of silicone tube stent) is commonly performed for non-resolving tearing

  • The goal of surgery is improved tearing.

  • The surgery is usually performed under general anesthesia.

  • The surgery usually takes about 5 minutes per eye (simple probing) or 10-15 minutes per eye (placement of silicone stent).

  • The patient may be in the operating area for 30 minutes or more.

  • The patient usually returns to home the same day as surgery.

  • Expect to administer antibiotic eye drops for about 1 week after surgery.

  • Expect an after-surgery exam about 1 week after surgery. Often this can be performed with telemedicine.

  • If a silicone tube stent is placed, expect tube remove about 3 months after surgery. Tube removal is performed in the office without additional anesthesia exposure.

  • Your surgeon will discuss patient-specific and surgery-specific risks prior to scheduling surgery.

    * The surgery plan and goals are customized for each patient: the above represent general trends in therapy. Your treatment plan, goals, and expectations may differ.