Nasolacrimal duct obstruction involves permanent blockage in which tear fluid accumulates within the nasolacrimal duct where it becomes irritated and infected. Generally, the eyes have enough tear fluid to keep them moist but some young children seem to have a continuous overflow of tears.
The tear fluid leaves the eye via small-sized openings on the edges of the eyelids. After going through these openings, the fluid drains into the nose via the nasolacrimal ducts.
Close look on nasolacrimal ducts
The nasolacrimal ducts start below the skin at the corners of the eye close to the nose. These ducts go down via the bones of the face and open within the nose. Normally, there is only a small amount of tear fluid that the nose does not get wet. The link between the eye and nose is evident especially when crying.
Indications of nasolacrimal duct obstruction
If a child appears to have continuously overflowing tears, it might indicate a nasolacrimal duct obstruction. The doctor will check for the following symptoms:
- Hazy or yellowish fluid in the tears
- Overflow of tears without irritation or redness of the eye
Management
A thorough assessment is required so that the doctor can decide whether a child has an obstructed nasolacrimal duct and start the appropriate treatment.
If a child has obstruction, the doctor will recommend a simple treatment. You can utilize a warm compress. All you have to do is apply a warm, moist washcloth on the eye of the child a few times throughout the day to facilitate the drainage of the fluid within the duct. It is also beneficial to gently massage the area in between the eye and nose with a clean finger. This will promote drainage of fluid and open the clogged part of the nasolacrimal duct. The doctor will explain how this is done and the frequency it must be carried out throughout the day.
What to do for persistent obstruction?
Remember that it can take up to a year for the nasolacrimal duct to open up on its own. In case the obstruction is causing other issues, the doctor might recommend a procedure to open up the duct which is known as nasolacrimal duct probing and it is usually required if infection is present. In most cases, suitable antibiotics are given prior the procedure if infection is present.
The procedure can be performed in the clinic and a local anesthetic is administered to numb the eye. In most cases though, the doctor might prefer to perform the procedure in the operating room with general anesthesia.
A slim probe made of metal similar to a wire passes via the cavity in the eyelid. The wire probe passes via the nasolacrimal duct down to where it opens within the nose. The doctor will inject clean water via the nasolacrimal duct to ensure that it can go through. Once the probe was able to clear a path for the tears, it is slowly removed. The procedure is highly effective in opening up nasolacrimal duct obstructions and preventing the overflow of tears.