Congenital Tear Duct Obstruction Surgery
A simple probing procedure that opens a tear duct that is blocked from birth in babies, so tears can drain normally again.
What is congenital nasolacrimal duct obstruction?
Congenital nasolacrimal duct obstruction is the condition in which the tear ducts are blocked from birth in newborns and infants. Normally, the tears produced in the eyes flow through the tear duct that opens into the nose, cleaning the eye surface and keeping the eyes moist. However, in some babies this duct may be blocked from birth and the tears cannot flow toward the nose. In this case, symptoms such as constant watering, crusting, and infection appear in the eye. Congenital nasolacrimal duct obstruction usually opens on its own in the first months after birth. However, in some babies this blockage may be persistent and require treatment. Generally, a surgical procedure is needed when the child is 10–12 months old.
Symptoms of congenital nasolacrimal duct obstruction
Tear duct obstruction in babies usually shows itself with the following symptoms: constant watering in the eye (epiphora), frequent crusting around the eye, redness and irritation in the eye, sticking of the eyelids (especially after waking up), and recurrent eye infections. These symptoms can negatively affect eye health, especially in babies, and when left untreated the risk of infection increases.
Treatment methods for congenital nasolacrimal duct obstruction
Treatment of tear duct obstruction in babies usually depends on the age, the severity of the blockage, and the frequency of the symptoms. In the first stage, surgical intervention may not be necessary; the blockage is expected to open with simple methods.
Massage and eye cleaning
Nasolacrimal massage: a special massage technique demonstrated by the doctor may be applied to help open the nasolacrimal duct. This massage applies gentle pressure over the tear sac to help the tears pass through the duct. Regular application of the massage can help the blockage open by natural means. Eye cleaning: eye cleaning should be done to ease the symptoms of crusting and infection in the eye. The area around the eye is carefully cleaned with a clean and sterile cloth or cotton.
Antibiotic treatment
If there are frequently recurring infections in the eye, the doctor may prescribe antibiotic eye drops or ointment. These medications control the infections but do not directly treat the blockage in the tear duct.
Tear duct probing (opening the tear duct with a fine tube)
If conservative treatments such as massage and eye cleaning do not work, a simple surgical procedure called probing is usually performed when the baby is 10–12 months old to open the tear duct obstruction. This procedure is carried out by inserting a fine tube into the tear duct to open the blockage. The thin membrane at the end of the duct is generally opened with this method.
Tear duct probing surgery
Tear duct probing is the most frequently performed surgical procedure to open nasolacrimal duct obstruction in babies. This procedure is usually performed when the baby is 6–12 months old, because the chance of the blockage opening on its own decreases after this period. Probing is a quick and effective method and gives successful results in the great majority of cases.
Stages of the probing procedure
Anesthesia: probing is usually a short surgery, and for this reason it is performed under light sedation or general anesthesia. This ensures that the baby stays comfortable and still during the procedure. The probing procedure: the surgeon places a fine metal probe into the tear duct. This probe is used to open the blocked nasolacrimal duct. When the blockage is opened, the flow of tears toward the nose is restored. The procedure usually takes 10–15 minutes. Use of a temporary tube: in some cases the surgeon may place a temporary tube in the tear duct so that the blockage does not recur. This tube keeps the tear duct open and is removed after a few weeks. After surgery: once the probing procedure is completed, the baby is discharged the same day. There may be mild swelling and watering around the eye, but this usually resolves within a few days.
The recovery process after surgery
The recovery process after probing surgery is usually quick and uneventful. However, regular doctor's check-ups should be carried out to make sure the baby's tear duct has reopened.
The first days
Mild discomfort in the eye: there may be mild discomfort in the baby after surgery, but this is usually short-lived. Mild swelling in the eye: there may be mild swelling and watering around the eye. These symptoms pass within a few days after the operation.
Eye drop use
The doctor may prescribe antibiotic eye drops to reduce the risk of infection after surgery. These medications should be used regularly.
Regular check-ups
After surgery, the doctor will carry out several follow-up examinations to make sure the tear duct stays properly open. If the tear duct becomes blocked again, placement of a tube or additional treatment may be required.
The benefits of the operation
Protection of eye health: opening the tear duct eliminates the risk of infection caused by tears accumulating in the eye and protects eye health. Relief in the eye: after probing surgery, the constant watering and crusting are eliminated and the baby is relieved of the bothersome symptoms in the eye. High success: tear duct obstruction surgery has very high success in babies in particular and usually provides a permanent solution.
The risks of the operation
Tear duct obstruction surgery is generally a safe procedure, but there are some rare risks. Infection: the risk of an infection developing around the eye after surgery is rare, but the use of antibiotics reduces this risk. Recurrence of the blockage: in rare cases the tear duct may become blocked again, in which case additional surgery may be required. Bleeding or swelling: temporary bruising and swelling may occur around the eye, but this usually resolves in a short time.
Do not postpone treatment of congenital nasolacrimal duct obstruction
If your baby has symptoms such as constant eye watering, crusting, and infection, it may be congenital nasolacrimal duct obstruction. If left untreated, this condition can increase the risk of infection and negatively affect eye health. Early diagnosis and treatment is the most effective way to protect eye health.
This page is for general information and does not replace a personal examination. The right approach is decided together after an eye examination.