What is it about ?
Tears, produced by the lacrimal glands, are used to keep the eyes moist. The tear glands are located in the lining of the eye. To prevent our eyes from constantly watering, they are equipped with an evacuation system. It is made up of two orifices (tear points) located on the edge of the eyelids, right next to the nose. Each tear point is connected to the tear duct which ends in the tear sac. From there the tears flow to the nose. That’s why someone who cries has to blow their nose.
If there is a severe narrowing (stenosis) of the tear duct, the tears are not removed properly. This anomaly is often already present at birth. The narrowing is then almost always located where the tear duct opens into the nose. In adults, the condition is rare and may be due to infection, a build-up of salt crystals at the bottom of the tear sac, or sometimes an injury or tumor.
What is its frequency?
6-20% of newborns show signs of narrowing of the tear duct.
How to recognize it?
After 2-4 weeks of life, you notice that the baby’s eyes are constantly wet and watery. These children also more often suffer from inflammation of the lining of the white of the eye and the inside of the eyelids (conjunctivitis). The eyelids can then be stuck together, especially in the morning. Sometimes the baby rubs his eyes because they are itchy.
In adults, the entire tear sac may become inflamed. A red swelling then develops between the inner corner of the eye and the wing of the nose. It empties when you press it with your finger.
How is the diagnosis made?
It is easy to make the diagnosis, and usually a simple visual examination is sufficient.
What can you do ?
The narrowing resolves spontaneously before the age of 8 months in 8 out of 10 children. You can therefore calmly wait for the spontaneous development. It may be helpful to empty the tear sac with light finger pressure just under the eyes on the side of the nose. Make sure your fingernail is short so as not to damage the eye. If you do it right, you will see a secretion leaking into your eye. It should be done 4 or 5 times a day. Carefully wipe off the secretion each time.
If there is no improvement after one year of age, consult an eye specialist (ophthalmologist).
What can the doctor do?
The doctor will always choose to wait for spontaneous healing while observing the progress. If there are signs of infection, he may prescribe antibiotic-based eye drops. He explains to you how to empty the tear sac and put the drops.
If the problem does not resolve on its own, you will be referred to an ophthalmologist for a tear duct probing. Under local anesthesia, a small tube is then inserted to open the tear duct and rinse it. This procedure does not necessarily have to take place in the hospital.
A narrowing of the tear duct in adults is also treated by probing and rinsing. Sometimes surgery is needed, depending on the underlying disease.
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