Blocked Tear Duct: Treatments, Causes, and What You Need to Know

What Is a Blocked Tear Duct?

A blocked tear duct, also called nasolacrimal duct obstruction, occurs when the drainage system that normally carries tears from your eyes to your nose becomes partially or completely blocked. This prevents tears from draining properly, causing them to pool in your eyes and spill over onto your face.

Your lacrimal glands are constantly producing tears to keep your eyes moist and wash away debris. Under normal circumstances, these tears drain through tiny openings in the inner corners of your eyelids (called puncta), travel through small channels, and eventually empty into your nose. That’s why your nose runs when you cry.

When this drainage pathway is blocked, tears have nowhere to go. The result? Watery eyes, blurry vision, and sometimes infection.

Blocked Tear Duct Symptoms

The symptoms of a blocked tear duct can range from mild to severe, depending on whether the blockage is partial or complete. Here’s what to watch for:

• Excessive tearing or watery eyes that won’t stop, even when you’re not emotional or in windy conditions
• Tears that overflow onto your cheeks, especially in cold weather or wind
• Recurring eye infections, such as conjunctivitis (pink eye)
• Mucus or discharge from the eye, often yellow or green if infection is present
• Swelling or tenderness near the inner corner of the eye, close to the nose
• Blurred vision from the constant pooling of tears
• Crusting on the eyelids, particularly after sleep
• Pain or discomfort in the area around the tear duct, especially if an infection develops

If you’re experiencing any of these symptoms, especially if they persist for more than a few days or are accompanied by signs of infection, it’s time to see an eye doctor.

Why Do My Eyes Keep Watering?

While there are several potential causes of excessive tearing, a blocked tear duct is one of the most frequent culprits.

When your tear drainage system is blocked, your eyes continue producing tears, but those tears can’t drain away. As a result, they accumulate and eventually overflow. 

Ironically, even though your eyes are constantly watery, you might also experience dryness or irritation, because the tears aren’t being distributed evenly across the surface of your eye.

Other causes of watery eyes can include:

• Allergies or irritants
• Eyelid problems, such as ectropion or entropion
• Infections or inflammation
• Foreign objects or debris in the eye

An eye doctor can help determine whether your watery eyes are due to a blocked tear duct or another underlying issue.

What Causes a Blocked Tear Duct?

Congenital Blockage (Present at Birth)

Many infants are born with a blocked tear duct, but it often resolves on its own within the first year of life. If your baby has excessive tearing in one or both eyes, this could be the reason.

Age-related Changes

As we age, the tear ducts can narrow or become blocked due to changes in the tissues around the drainage system. This is one of the most common causes in older adults.

Chronic Inflammation or Infection

Repeated eye infections, sinus infections, or chronic inflammation of the tear duct (dacryocystitis) can cause scarring and narrowing of the drainage pathway.

Injury or Trauma

Facial injuries, broken bones near the tear ducts, or damage from surgery can block or damage the tear drainage system.

Nasal or Sinus Problems

Nasal polyps, chronic sinusitis, or structural issues in the nose can obstruct the opening where tears normally drain.

Tumors or Growths

In rare cases, tumors in the nose, sinuses, or tear duct system can cause a blockage. This is more common in adults and requires prompt evaluation.

Medications

Certain medications, particularly some chemotherapy drugs and eye drops used long-term, can cause tear duct blockages.

Previous Eye Surgery

Some eye surgeries, including certain glaucoma procedures, can inadvertently affect tear drainage.

Blocked Tear Duct Treatment Options

Most blocked tear ducts are treatable. The approach depends on the severity of the blockage, the underlying cause, and your age.

At-home Care

For mild cases, especially in infants, conservative treatment may be all that’s needed:

• Warm compresses: Apply a clean, warm compress to the inner corner of the eye for 5-10 minutes, several times a day. This can help open the blockage and reduce inflammation.
• Gentle massage: Your eye doctor may show you how to massage the tear duct area to encourage drainage. This technique is particularly effective in infants.
• Good eyelid hygiene: Keep the area clean and free of crusts or discharge using a gentle eyelid cleanser or warm water.

Antibiotic Eye Drops or Ointments

If there’s an infection present, your eye doctor may prescribe antibiotic drops or ointments to clear the infection before addressing the blockage itself.

Tear Duct Probing and Irrigation

For persistent blockages, especially in infants and young children, a simple in-office procedure called tear duct probing may be recommended. A thin probe is gently inserted into the tear duct to open the blockage, followed by irrigation with saline to flush out any debris.

This procedure is quick, often done under local anesthesia or light sedation, and has a high success rate.

Balloon Catheter Dilation

In cases where probing alone isn’t enough, a balloon catheter dilation may be used. A small, deflated balloon is inserted into the tear duct and then gently inflated to widen the passageway. This technique is minimally invasive and effective for many patients.

Stenting or Intubation

For more complex or recurrent blockages, a small tube (stent) may be placed in the tear duct to keep it open while it heals. The stent is typically left in place for several months and then removed in a simple office procedure.

Dacryocystorhinostomy (DCR)

For severe or chronic blockages that don’t respond to other treatments, a surgical procedure called DCR may be necessary. This surgery creates a new drainage pathway from the tear sac directly into the nose, bypassing the blocked duct entirely.

DCR is highly effective and is usually performed as an outpatient procedure. Recovery is typically straightforward, and most patients experience significant relief from their symptoms.

When to See an Eye Doctor for a Blocked Tear Duct

While some cases of blocked tear ducts resolve on their own, especially in infants, many require professional evaluation and treatment. You should see an eye doctor if:

• Excessive tearing persists for more than a few days
• You notice discharge, especially if it’s yellow, green, or thick
• There’s swelling, redness, or pain near the inner corner of your eye
• You develop signs of infection, such as fever or spreading redness
• Your vision becomes blurry or is affected by the constant tearing
• You’ve tried at-home remedies without improvement
• The problem keeps recurring

Early intervention can prevent complications like chronic infections, damage to the tear drainage system, or discomfort that interferes with your daily life.

Specialized Care at Cascade Eye & Skin Centers

If one of our doctors suspects that you may have a blocked tear duct, you will be referred to one of our two oculoplastics specialists, Aimee N. Lam, MD, or Vladimir S. Yakopson, MD, FACS. Oculoplastic surgeons specialize in conditions affecting the structures around the eyes, including the tear drainage system, eyelids, and orbit.

Preventing Blocked Tear Ducts

While not all blocked tear ducts are preventable, there are steps you can take to reduce your risk:

• Treat eye and sinus infections promptly to prevent inflammation and scarring
• Practice good eyelid hygiene to reduce the risk of infection
• Protect your eyes from injury by wearing safety glasses when needed
• Manage chronic conditions like allergies or sinus problems that can affect tear drainage
• Avoid prolonged use of certain eye drops unless prescribed by your eye doctor

Get Expert Eye Care at Cascade Eye & Skin Centers

If you’re dealing with excessive tearing, recurring infections, or discomfort from a blocked tear duct, you don’t have to live with it. At Cascade Eye & Skin Centers, our experienced ophthalmology team provides comprehensive evaluation and treatment for blocked tear ducts in patients aged 4+.

Serving patients throughout the South Sound, including Auburn, Bonney Lake, Gig Harbor, Puyallup, Sunrise, and University Place, we’re here to help you see clearly and comfortably.

Schedule an appointment online with one of our eye doctors today and get the relief you deserve.