Tears normally drain through small openings in the corners of the upper and lower eyelids and enter the nose through the nasolacrimal duct. Tear duct obstruction prevents tears from draining through this system normally.

The most common cause of blocked tear ducts is the failure of a membrane at the end of the tear duct to open normally at or near the time of birth. Some of the other causes include infection, a narrow duct system or nasal bone obstruction.

Blockage of the drainage system causes tears to well up on the surface of the eye and overflow onto the eyelashes, eyelids, and down the cheek. This usually occurs within the first days or weeks of life.

The eyelids can become red and swollen (sometimes stuck together) with yellowish-green discharge when normal eyelid bacteria are not properly flushed down the obstructed system. Severe cases result in a serious infection of the tear duct system (dacryocystitis).

Fortunately, tear duct obstruction resolves spontaneously in a high percentage of cases. When obstruction is persistent, one or more of the following treatments may be recommended: tear duct massage, topical antibiotic eye drops, tear duct probing, balloon tear duct dilation, and/or tear duct intubation.

Source: American Association for Pediatric Ophthalmology and Strabismus

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