Correction of Nasolacrimal Duct Obstruction
Do your child’s eyes look irritated and have a crusty substance on the eyelashes? Does your child produce a lot of tears, even when not crying? These may be signs of a nasolacrimal duct obstruction, a blockage that impedes normal tear flow. Fortunately, this condition is very treatable; pediatric ophthalmologist Dr. Carolyn Graeber has helped many young patients to overcome duct obstruction.
Ordinarily, tears drain through tear ducts (or tubes) that extend from the inner corner of the eye to the nose. However, about 5% of babies are born with a blockage or faulty opening in their tear ducts that makes tear drainage difficult. When tears cannot drain normally, the child may have overly lubricated eyes or eyes that discharge a yellowy mucus. It can take over a month to notice that your child has this problem since tear production does not begin in newborns for a few weeks.
What Causes Nasolacrimal Duct Obstruction and How Is It Diagnosed?
Although nasolacrimal duct obstruction can occur at any age, most cases are congenital (meaning they are present at birth). Usually, this is because a membrane is blocking the nasolacrimal duct from birth. In older patients, nasolacrimal duct obstruction is often attributed to a facial injury, a tumor, an infection or certain medications.
Dr. Graeber conducts an examination to determine the source of discharge and tearing. A tear drainage test uses a drop of dye in each eye to determine if the drainage system is open. (If the dye remains in the eye for several minutes, it is a sign of a blockage.)
Treatment for Nasolacrimal Duct Obstruction
For most patients, Dr. Graeber begins with what doctors call a “conservative” approach. This involves teaching the parents how to gently massage the area over the duct a few times per day to help place pressure on the blockage and open it without surgery. Parents can also administer antibiotic eye drops to help minimize discharge from the eye (although this medicine will not unblock an obstruction in the duct). Please use the eye drops as instructed by Dr. Graeber.
The reason for being conservative is that the blocked tear ducts often improve on their own in most children, usually clearing up by the child’s first birthday. Therefore, it is preferable to monitor nasolacrimal duct obstruction than to pursue a more invasive treatment that may not be necessary.
If these conservative treatments do not sufficiently help your child, Dr. Graeber may recommend a surgical procedure to open the duct. This is an outpatient procedure that is successful for almost all patients.
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Even though nasolacrimal duct obstruction goes away on its own for many young patients, it is important to monitor and gently treat the condition to ensure it does not become more serious. If you are concerned that your child’s tears are not draining properly, please schedule an appointment with Dr. Graeber at your soonest convenience.