Lacrimal System Obstructions

Conveniently located to serve Fort Myers

tear duct drawingLacrimal glands produce tears.  Tears are then spread by blinking of the eyelid. The nasolacrimal duct drains tears from the eyes through an inner tube into the nose.  Many conditions may effect the proper functioning of this vital system.  If the lacrimal duct does not produce enough tears, dry eyes may occur.

Causes of Lacrimal System Obstructions

Some causes are:

Tear duct obstruction: If the nasolacrimal duct is not open appropriately, tearing may occur. Occasionally tears may become stagnant in the area and become infected. An infection causing the blockage can be treated with medications.

Congenital obstruction: Approximately 7 % of infants are born with obstruction of the tear duct. Infants with a blocked tear duct will often have a membrane covering the opening that empties into the nose.Initial treatment involves massaging the area.  If the condition persists, the tear duct may need to be probed.  If the tearing continues, a more advanced procedure may be necessary which requires placement of a tube in the duct to keep it patent.

This process, called intubation, involves the insertion of thin tubes through the puncta (one or both). The tube passes through the nose and into the tear drainage system. The tube(s) are kept in place for three months.

Injury: A facial injury can lead to a temporary blockage of the tear ducts. If that is the case, the patient might have to wait for a few months to see if the condition improves on its own. In many cases, invasive treatments will not be required.

Acquired obstruction: The most common procedure for correcting a blocked tear duct in an adult is called a DCR (Dacryocystorhinostomy).  This procedure requires a new passage to be created between the blocked sac into the nose.  A stent may be placed to temporarily to keep the duct open while the passage heals.  If the obstruction cannot be opened, a glass “Jones tube” may need to be placed.

Dacryocystorhinostomy, depending on the location and the extent of the blockage, may be performed using these two methods:

  • External dacryocystorhinostomy: An incision is made on the side of the nose near the lacrimal sac. The lacrimal sac and the nasal cavity are connected after placing a stent. The incision is then closed up with stitches.
  • Endonasal dacryocystorhinostomy: This process involves using a microscopic camera to insert instruments required for the procedure through the nasal opening. This is a non-invasive surgery and leaves no scars.

Additional Treatment Options

In cases where the abovementioned solutions are not called for, the following treatment options may be performed to resolve lacrimal system obstructions.

Dilation or Flushing: Doctors can enlarge the puncta using a dilation instrument. They then administer a thin probe into the tear drainage system of the infant whose condition is not improved by massaging.

Among adults, this procedure may be conducted to flush or irrigate the tear duct using the probe. This can be used to provide temporary relief.

Balloon Catheter: The process involves inserting a thin tube through the puncta into the tear drainage system. The tube is attached to a deflated balloon at its tip. The doctor then opens the blockage by inflating and deflating the balloon.

Schedule Your Informative Consultation

Contact our office for a consultation regarding lacrimal system obstructions in Fort Myers or call 239-947-4042.

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