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Lacrimal System

We treat obstructions of the lacrimal gland so your eyes water properly and remain healthy.

The lacrimal gland produces tears that enter into the “duct” that drain the tears from the eye into the nose. The most common symptoms are excess tearing (tears may run down the face) and mucous discharge. If one has a plugged up “tear duct,” not only will tears spill over the eyelids and run down the face, but also the stagnant tears within the system can become infected. This may lead to recurrent red eyes and infections. The excessive tearing can also produce secondary skin changes on the lower eyelids.

Nasolacrimal Duct Obstruction (NLDO) is very common in infants. Children are frequently born with an obstruction within the “tear duct.” In fact, 6% of all children are born before their tear ducts are open. The stagnant tears within the “tear duct” often become infected causing pus (heavy matter) to collect between the eyelids. Antibiotics may help some of the symptoms, BUT this is not cure for the blockage. Such obstructions may resolve spontaneously within the first few months of life. In fact, 95% of these children will show resolution before their first birthday. If it does not resolve surgery may be necessary.

A blockage can present in one a number of ways: as a simple obstruction, congenital fistula (as seen to the left), acute dacryocystitis, congenital dacryocele or mucocele. The very end of this duct is the most common place for blockage to occur. This site is called the valve of Hasner at the distal nasolacrimal duct and may represent failure of canalization of the epithelial cells that form the duct.

Sometimes the best treatment is waiting, as many blockages open on their own given time. Massaging from the tear sac inward also may help create a pressure wave that can open the blockage.

Acquired (ADULT-ONSET) Nasolacrimal Duct Obstruction or tear duct blockages in adults can be caused by sinus disease, nasal polyps, diseases or tumors, but is most often of unknown cause.