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  • Chris Thiagarajah MD

Do I have a blocked tear duct?



This is one of the most common questions that I get from patients in Denver who are tearing. There are lots of causes of a tearing eye and this is a discussion of tearing to understand what the symptoms are and how to tell if you have a tear duct blockage.

The eyes get wet because a gland called the lacrimal gland is located near the eye and has ducts that exit onto the eye surface. This gland is necessary to make the eye wet and help us produce tears. In the corner of the eyelid there is a tear duct hole (also called puncta). There is one on the upper eyelid and lower eyelid. Tears flow into the hole and exit into the tear duct in the nose.


So what are the symptoms of blocked tear duct?

Tearing over the cheek

Wet eyes

Tearing on a windy day

Sometimes the tear duct can house an infection and as a result there can be symptoms of a long term tear duct infection. These include:

Waking up with discharge in the eyelid

Painful corner of the eye near the tear duct

Sticky discharge of the eye

How does one test for a tear duct blockage? There are three main tests that show if you have a tear duct infection:

Dye Disappearance Test

This is where the doctor puts an orange dye in the eye surface and sees if it drains away from the surface of the eye. After a few minutes the eye surface should be white. If the tears and dye don’t flow through the tear duct normally, the orange dye remains



Irrigation of the tear duct

A small syringe and tube is used to put water into the tear duct system to see if the water flows into the nose. If the water flows into the nose, the system is most likely open. If not, there is a blockage. Sometimes pus comes out the tear duct when this is done showing that there is an infection.

Dacryoscintillogram

This is an xray where a Technicium-99 is placed in the eye and xrays are taken to see if the dye goes into the tear duct. In some patients, the tear duct has a blockage where irrigation allows water to go through but the natural flow of tears can’t go down the tear duct system.

These tests are done in my office in Denver as a tear duct specialist. The tear duct is a unique system that oculoplastic surgeons are trained to treat. Understanding the basic testing of the system allows patients with tearing to understand what will happen in their visit to my office in Denver.

There are some other causes of tear that are not included in this discussion that are more complex:

Functional tear duct blockage

Canalicular Stenosis

Punctal Stenosis

Lacrimal Pump Failure

These can account for patients who have tearing who are told by some doctors “nothing can be done” or “live with it”. An oculoplastic specialist may be able to fix these problems because of their unique experience.

What can cause tear duct blockage?

Aging (most common cause)

Infection (pink eye)

Radiation

Previous Surgery near the tear duct and Scarring

Cancer on the tear duct

Taxotere and other chemotherapy agents

Radioactive Iodine

For further information about you or your family members tearing, contact my office for an appointment. Without an exam it can be very difficult to determine why someone is tearing.


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