Nasolacrimal Duct Obstruction (Stenosis)
What is Nasolacrimal Duct Obstruction?
The normal nasolacrimal duct allows tears to drain into the nose which is then absorbed by the moist mucosal lining inside the nose. The nasolacrimal duct being narrowed or blocked is a common condition.
Who is at risk of Nasolacrimal Duct Obstruction?
- It can occur in anyone and there is usually no specific cause.
- Age – it is more common with increasing age although it can also occur in young people or children, including babies who can be born with this.
- Facial trauma resulting in nose fractures
- Hay fever or sinus problems can cause the mucosa lining inside the nasolacrimal duct to become swollen and lead to narrowing or obstruction.
What are the symptoms of Nasolacrimal Duct Obstruction?
Like the drain in a kitchen sink being blocked, this can lead to the overflowing of water/tears. When mild, the eye may feel wet. When severe, this can constantly drip down the cheek. Patients are often embarrassed when others enquire why they are crying. Frequent wiping with a tissue can cause the eyelid to become sensitive or sore. The eye can also become red by frequent rubbing. An eye filled with tears can affect vision and is particularly a problem for driving.
Like the water in a river becoming dirty when it is obstructed, tears can become sticky with mucus when the nasolacrimal duct is not draining well. When severe, the eyelids can become stuck together on waking in the morning and need to be washed or pried open.
There is a small chance that an infection can develop in the lacrimal sac (dacryocystitis). If this occurs, the inner corner of the eye (towards the nose) can become red, swollen and painful.
How is Nasolacrimal Duct Obstruction diagnosed?
Eye examination including checking to ensure that the eyelids are in normal position and that there are no conditions causing excessive tear production (such as eyelashes growing inwards, dry eyes, allergy etc). Then a detailed examination is performed to check if the drainage through the nasolacrimal duct is normal, slowed or obstructed.
How is Nasolacrimal Duct Obstruction treated?
Initially lubrication and anti-inflammatory eyedrops can be tried to improve excessive tear production due to dry eyes or other conditions. If this is unsuccessful, then surgery needs to be considered. Nasolacrimal duct stenosis is a plumbing problem and therefore requires surgery to fix the plumbing. The narrowed nasolacrimal duct is too narrow to open and thus the solution is dacryocystorhinostomy (DCR) surgery which creates a new passage inside the nose for the tears to flow and bypass the obstruction.
What if Nasolacrimal Duct Obstruction is not treated?
The eye will continue to be watery and sticky. This is a nuisance but usually not dangerous to the eye or vision. If the watering is not too severe, it is reasonable to just put up with the symptoms. The exception is if dacryocystitis develops. This needs to be promptly treated by antibiotics, and then Dacryocystorhinostomy (DCR) Surgery subsequently to prevent further infections.
Eye conditions we treat
Explore the range of eye conditions we can help manage and treat for better vision and eye health.