How Do I Treat Blocked Tear Ducts?

Lacrimal duct obstruction is a common and frequently-occurring disease in ophthalmology. It is a disease that often occurs at the punctum, lacrimal canaliculus, the junction of the lacrimal sac and the nasolacrimal duct, and the lower nasolacrimal duct. Thoroughly, there is a risk of latent infection inside and outside the eye. Its treatment principle is to control the lacrimal sac inflammation, restore or establish a lacrimal lacrimal sac to the nasal drainage channel.

Basic Information

English name

lacrimal duct obstruction

Visiting department

Ophthalmology

Common causes

Congenital and developmental factors, inflammation, trauma, foreign body, tumor, iatrogenic injury, etc.

Common symptoms

Shed tears

Causes of lacrimal duct obstruction

1. Congenital and developmental factors

Congenital Hasner valve obstruction is the most common. There are congenital lacrimal atresia (including bone deformity leading to osseous nasolacrimal duct obstruction), congenital absence of lacrimal punctures, and deviated nasal septum. Recently, cases of lacrimal duct obstruction caused by ectopic teeth have been reported.

2. inflammation

Local inflammation of the eyes, such as trachoma, acute and chronic conjunctivitis, blepharitis, acute and chronic dacryocystitis, stye, and herpes eyelid. Inflammation of adjacent tissues, such as hypertrophic rhinitis.

3. Trauma

Lacrimal canaliculi are the most common. There are also mechanical damage to other parts, burns (heat or acid-base), and nasal and maxillary fractures involving the lacrimal duct.

4. Foreign body

Sand, lashes, etc.

5. tumor

Lacrimal sac tumors, tumors of the nose and paranasal sinuses.

6. Iatrogenic injury

Surgery (nasal and paranasal sinus surgery, oral and maxillofacial surgery), excessive or inappropriate lacrimal irrigation, probing. Radiation Damage Caused by Radiotherapy for Local Malignancies. Serious drug allergic reactions, such as reactions after vaccination.

7. Some patients have unknown causes.

Clinical manifestations of lacrimal duct obstruction

Overflow with tears

The main symptom of lacrimal passage is tearing.

2. Outer upper eyelid

Redness, swelling, and pain, and the eyelid margins sag laterally.

3. Swelling

It can be extended to the temporal and cheek areas. The lymph nodes in the ears are enlarged and tender. The inner eyelids can be palpable with solid masses.

4. When the eyelids are separated

The conjunctival congestion and edema were seen, the lacrimal gland tissue was congested and raised, and there were mucus-like secretions.

5. Other

May be accompanied by fever, headache, general discomfort, etc.

Lacrimal duct obstruction

Lacrimal tract irrigation test

The syringe was filled with a saline solution, and the flushing needle was connected. The saline solution was injected from the punctum into the lacrimal canaliculus.

2. X-ray film inspection

X-ray examination was performed after the lacrimal duct was injected with lipiodol.

Lacrimal duct obstruction diagnosis

Lacrimal tract irrigation test

Method of judging the obstruction or stenosis of the lacrimal duct according to the liquid discharge.

(1) Irrigation fluid is injected from the lower punctum and only part of the liquid enters the nasopharynx, and part of the liquid flowing back from the upper punctum is lacrimal stenosis.

(2) The irrigating fluid is all from the upper punctum point to the lacrimal duct lacrimal duct obstruction or nasolacrimal duct obstruction. If there is a large amount of mucus secretion flushing out for chronic dacryocystitis with nasolacrimal duct obstruction.

(3) The flushing fluid is all returned from the lower punctum. When the flushing resistance is large, the upper tear should be flushed again. If the lacrimal duct is unblocked, the lower lacrimal duct is blocked. The flow is blocked by the common tear duct.

2. X-ray film inspection

X-ray examination of the lacrimal duct after lipiodol injection can accurately identify the obstruction.

Lacrimal duct obstruction diagnosis

Probe through

Repeated exploration and progressively increasing the probe can be used to enlarge the nasolacrimal duct, which is effective for a few mild or fibrin adhesion obstructions, and it is difficult to have an effective scar. After probing, such as silk thread, gut, polyethylene or silicone tube, etc., leave it for 3 to 6 months to form a channel.

2. Block incision

There are various incision methods, such as special knife incision, electrocoagulation or electrolysis, retrograde incision from the road or in the nose.

3. Nasolacrimal duct surgery

After probing and expanding the nasolacrimal duct, a 1.5 to 3 mm inner diameter prosthesis was placed.

4. Dacryocystorhinostomy

The best way to block the dacryocystis is dacryocystorhinostomy.

5. Laser lacrimal plasty

A laser is used to open the narrow obstruction of the lacrimal canaliculus, lacrimal duct, or nasolacrimal duct, and combined with drug infusion, this surgical method can restore the physiological channels of the lacrimal duct.

Lacrimal duct obstruction prevention

1. Wash hands frequently and avoid rubbing eyes casually. It is recommended to wash your face under running water. Towels, handkerchiefs, and other items should be separated from others, and often washed and disinfected.

2. It is forbidden to swim in public swimming areas. Medical staff must also wash their hands after disinfection to prevent cross infection.

3. Where the working environment is windy, dusty, and other irritants, the environment should be improved and protective glasses should be worn to prevent conjunctivitis.

4. Publicity in public places such as bathrooms, restaurants, and swimming pools shall be publicized, regularly inspected and strengthened in management.