Are your eyes constantly watering? This could be a blocked tear duct (Nasolacrimal Duct Obstruction)!

Does your little one's eyes always tear? Or do you wake up in the morning with both eyes crusted over and your eyelids sticking together? Sometimes, even as an adult, you may have experienced tears constantly flowing from one eye for no reason. It's normal to feel a little scared when you see something like this. But the reason for this is often a condition called "blocked tear ducts," which we're talking about today. There's nothing to be afraid of, let's talk about everything in simple terms.

What is a Blocked Tear Duct?

Simply put, this means that the tears produced in our eyes do not drain properly, but get stuck somewhere in that system. In medical terms, we call this ``Nasolacrimal Duct Obstruction''.

Now, tears are essential for our eyes to function properly. Tears keep the eyes moist and lubricated. They also help the cornea get the oxygen it needs and protect the eye from germs.

The best example to understand this is the gutter on the roof of a house. Imagine, the gutter is there to collect the water that falls on the roof and carry it down a pipe. But what happens if this pipe gets clogged with leaves and dirt? The water does not go down, but flows out of the gutter. The same is true of our tear system. When the tears do not go down properly and get clogged, they start to flow out of the eye.

This is how our tear drainage system works:

Let's learn a little about this journey.

• Punctae: If you look in a mirror, you will see that there are two small holes on the inside of our upper and lower eyelids, near the nose. Tears begin to drain from the eye through these two holes called ``puncta'', which act like the holes in a water basin.
• Small canaliculi: The tears that enter through those two holes then go into two very fine tubes called ``canaliculi.`` These two tubes join together to form one small tube.
• Nasolacrimal Duct: The tears then travel into the nasolacrimal duct, which carries the tears into the nose.
• Hasner's Valve: At the bottom of this tear duct, where it opens into the nose, there is a valve called the ``Valve of Hasner''. Normally, this valve opens before we are born. However, some babies are not yet open when they are born. That is when congenital tear duct blockages are most common.

How common is this condition?

Blocked tear ducts are very common in newborns. According to surveys, this condition affects between 6% and 20% of newborns. However, it is not as common among adults.

What are the symptoms of blocked tear ducts?

There are several symptoms that can be seen in this condition. Sometimes this blockage can even lead to infections. Let's take a closer look at these symptoms.

Why do tear ducts get blocked like this?

There can be several reasons for this. Some are congenital, while others develop later in life.

Doctor, how do you diagnose this?

Usually, the doctor can get an idea of ​​this condition by asking about your symptoms and examining your eye and the surrounding area.

In addition, sometimes a simple test called the "Dye Disappearance Test" can be performed.

• This involves putting a drop of a special dye called ``fluorescein'' into your eye.
• This pigment glows under blue light.
• After about 5 minutes, the doctor checks to see if the pigment has left the eye or if it is still there.
• If the tear duct is working properly, this pigment should have been removed. If the pigment is still present in the eye, it indicates that there is a complete or partial blockage of the tear duct.

If another cause of the blockage is suspected, you may be referred for other specialized tests.

What are the treatments for blocked tear ducts?

This is a very treatable condition, but treatment methods vary depending on age and other factors.

Treatment for small babies

If a newborn baby has this condition, it will usually resolve on its own by the time it reaches its first birthday in about 90% of cases. However, it is best to treat it to prevent infection and speed up recovery.

• Massage Technique: This is the most important and effective treatment for babies. Your doctor will teach you the correct way to do this. By gently massaging the area between the inner corner of the eye and the nose in the right way, you can apply pressure to the valve that is not open and help it open.
• Antibiotics: If your eye is very pus-filled, meaning there is an infection, your doctor will prescribe antibiotic eye drops.

If the baby does not improve with this massage method after about a year, the doctor may refer the child to other treatment methods.

Treatment for the elderly and others

Massage is not effective for adults, so other methods are needed.

• Dilation, Probing, and Irrigation: This is a simple procedure.

1. Dilation: First, the small holes (puncta) in the eye are slightly widened with a special instrument.

2. Probing: A very fine instrument is then passed down the tube to find the blockage and attempt to remove it.

3. Irrigation: Finally, a saline fluid is passed through the tube to ensure that it is completely clean and well-opened.

• Balloon Dilation: Sometimes, if the duct is very narrow, a small device with a balloon is inserted into the duct and the balloon is inflated to widen the duct from the inside.

• Stenting or Intubation: If the duct repeatedly narrows, a very thin tube made of silicone (stent) may be temporarily placed inside the duct to keep it open. This tube is removed after a few months.

• Surgical Procedures: If no other treatment has been successful, surgery may be necessary.
• DCR (Dacryocystorhinostomy): This involves creating a new path for tears to flow into the nose, bypassing the blocked area.
• CDCR (Conjunctivodacryocystorhinostomy): This is a more complex surgery. It is performed in cases where the entire tear system is reconstructed.

Are there ways to prevent blocked tear ducts?

In fact, many of the things that cause this are unpredictable and beyond our control. Therefore, there is no way to prevent this 100%.

However, we can do the following to reduce the risk of infections that can lead to blockages:

• Always wash your hands thoroughly with soap.
• Stop touching and rubbing your eyes unnecessarily.
• If you wear contact lenses, clean them properly and replace them on time.
• Do not share eye makeup (such as mascara, eyeliner) with others. Also, replace them every 3-6 months.