What is Tear (Nasolacrimal) Duct Obstruction? Symptoms and Treatment
Tear duct obstruction is seen in about 5 percent of newborn babies. Op. Dr. Yusuf Avni Yilmaz, an ophthalmologist at Anadolu Medical Center, stated that the complaints of tear duct obstruction start a few weeks after birth, and said “While the most common cause of watering of eyes is tear duct obstruction in babies, there are other causes as well. The most important one of these is congenital glaucoma, i.e. eye pressure. Congenital glaucoma is a much more serious condition compared to tear duct obstruction. Besides simple congenital defects obstructing the tear duct, tumors and cysts should be considered”. Here are the recommendations of Op. Dr. Yusuf Avni Yilmaz, an ophthalmologist at Anadolu Medical Center.
The structures of the tear system begin to form at week 5 of pregnancy, and the tear duct begins to form at week 8 of pregnancy. This formation and development continue throughout pregnancy. Tears form in the lacrimal gland, fill the sac through small ducts and flow into the nasal cavity through the tear duct. The contraction of the eyelid muscles acts as a pump to drain the tears into the nasal cavity. Congestion anywhere in this system results in watering of eyes.
Tear Duct Obstruction: Congenital glaucoma should also be evaluated during eye examination
Tear duct obstruction in newborn babies can occur anywhere along the system and is more common where the tear duct opens into the nose. Complaints begin a few weeks after birth. The first finding is watering of eyes in general. But as the situation continues, the yellow discharge, known as burrs, accompanies watering. While the most common cause of watering of eyes is tear duct obstruction in babies, there are other causes as well. The most important one of these is congenital glaucoma, i.e., eye pressure. It should be considered in differential diagnosis. Congenital glaucoma is a much more serious condition compared to tear duct obstruction. Besides simple congenital defects obstructing the tear duct, tumors and cysts should be.
Tear Duct Obstruction: Treatment should be given according to the cause of eye watering
Diagnosis begins after a careful examination. The character of the eye watering and the presence of other concomitant findings give idea. If necessary, additional tests such as eye pressure measurement, corneal diameter measurement, and tear duct imaging can be made after the baby is put to sleep. Treatment should be administered based on the cause of eye watering. Since the cause is often congenital tear duct stenosis or obstruction, treatment should be divided into two. Initially, non-invasive treatment is recommended, the main element of this treatment is the massage of the lacrimal sac. The aim here is to increase the pressure in the sac by massaging it and to release the membrane at the end of the tear duct causing the obstruction. Most of the cases improve by 1 year of age with appropriate massage. In addition to the massage, if the watering in the eye turns into yellow discharge, an infection should be considered and the necessary treatment should be given.
Tear Duct Obstruction: There are treatment modalities from drug therapy to surgical intervention
The second treatment option is probing of the tear ducts if the condition does not improve until one year of age despite massage, or if the baby is younger than one year old and has an uncontrollable tear duct infection. This procedure is performed under general anesthesia and takes a short time. The baby does not need to be anesthetic for a very long time. The procedure yields a remarkable result.
The treatment of eye watering, other than simple tear duct obstruction, is entirely directed towards the reasons. Congenital glaucoma is a serious condition that should be considered primarily. There are treatment modalities from drug therapy to surgical intervention in this case. For conditions such as tumors, cysts, etc. that obstructs the tear system, it is necessary to administer a treatment that eliminates the cause.
Tear Duct Obstruction: Treatment should not be delayed
If the treatment of tear duct obstruction is delayed, some complications may develop due to frequent infections. In addition, the success of probing decreases day by day after 12-15 months. While the problem will be solved with a simple procedure such as probing in case of early diagnosis, extended operations will be needed after one year of age. Delayed diagnosis of congenital glaucoma can also cause severe permanent vision loss.
