Summary about Disease
Lacrimal duct obstruction, also known as nasolacrimal duct obstruction (NLDO) or blocked tear duct, occurs when the tear drainage system of the eye is partially or completely blocked. Tears cannot drain normally, leading to excessive tearing and other eye problems. The condition can affect people of all ages, from newborns to adults.
Symptoms
Excessive tearing (epiphora)
Recurrent eye infections (conjunctivitis)
Blurred vision (temporary, due to excessive tearing)
Painful swelling near the inner corner of the eye
Crusting of the eyelids
Mucus or pus discharge from the eye
In infants, a constant wetness of the eyelids
Causes
Congenital Blockage: Many infants are born with a blocked tear duct (most common). This often resolves on its own within the first year.
Infection: Eye infections or inflammation can cause scarring and blockage.
Injury: Trauma to the face or nose can damage the tear ducts.
Age-related Changes: Narrowing of the tear ducts can occur with age.
Tumors: Rarely, tumors in the nose or sinuses can press on the tear ducts.
Dacryoliths: Small stones (dacryoliths) can form in the tear ducts and cause obstruction.
Nasal polyps: These can block the opening to the tear duct.
Medicine Used
Antibiotic Eye Drops/Ointments: Used to treat infections associated with the obstruction (e.g., conjunctivitis). Examples include erythromycin, polymyxin B/trimethoprim, or ciprofloxacin.
Topical Steroids: May be prescribed with antibiotics to reduce inflammation.
Decongestants: Oral or nasal decongestants might be used to reduce swelling in the nasal passages that could be contributing to the blockage.
Is Communicable
Lacrimal duct obstruction itself is generally not communicable. However, if the obstruction leads to a secondary eye infection (like conjunctivitis), that infection might be communicable, depending on the cause (viral or bacterial).
Precautions
Hygiene: Wash hands frequently, especially before touching the eyes.
Avoid Sharing: Do not share towels or washcloths if there's an infection.
Cleanliness: Keep the affected eye area clean and free of discharge.
Avoid Irritants: Protect eyes from irritants like smoke, dust, and allergens.
Follow Doctor's Instructions: Adhere to prescribed medications and follow-up appointments.
How long does an outbreak last?
The duration of symptoms varies depending on the cause and treatment.
Congenital Blockage (Infants): Often resolves within 6-12 months.
Infection-Related: Symptoms improve within days to weeks with appropriate antibiotic treatment.
Chronic Obstruction: Symptoms may persist until the underlying cause is addressed (e.g., surgery).
How is it diagnosed?
Physical Exam: Assessing tearing, redness, and discharge.
Dye Disappearance Test: A drop of dye is placed in the eye, and the time it takes to disappear is measured. Delayed disappearance indicates a blockage.
Lacrimal Probing: A thin probe is inserted into the tear duct to check for blockages (typically performed by an ophthalmologist).
Irrigation: Fluid is flushed through the tear ducts to assess patency.
Imaging Studies: In some cases, imaging tests like a CT scan or dacryocystography (dye injected into the tear duct followed by X-ray) may be necessary to visualize the tear duct system.
Timeline of Symptoms
The timeline of symptoms varies based on the cause and severity.
Infants (Congenital): Symptoms (excessive tearing, wet eyes) are usually noticed within the first few weeks of life.
Infection-Related: Symptoms (tearing, redness, discharge) appear relatively quickly, often within a few days.
Age-Related/Gradual Blockage: Symptoms may develop gradually over weeks or months.
Important Considerations
Infants: Early intervention (massage, cleaning) is often successful in resolving congenital blockages.
Recurrent Infections: Persistent infections related to blocked tear ducts require prompt medical attention.
Surgery: Surgical options (e.g., dacryocystorhinostomy (DCR)) may be needed if other treatments are unsuccessful.
Underlying Conditions: Consider underlying conditions that might be contributing to the blockage, such as nasal polyps or tumors.