Blocked Tear Ducts: Surgery
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Surgery
Most babies born with a blocked tear duct will not need surgery. But when surgery is needed, probing is usually done. Probing involves passing a thin wire through the blocked tear duct to open it.
Probing may be done in the doctor's office under a local anesthetic (numbing eyedrops) for babies younger than 1 month of age. General anesthesia, which is usually done in an outpatient hospital setting, can be used for older babies. The doctor is able to evaluate your baby's tear duct more thoroughly if general anesthesia is used. Also, if needed, an additional procedure to resolve the blockage often can be performed at the same time and prevent the need for another surgery.
For adults, treatment for a blocked tear duct depends on its cause. Probing is typically not effective with adults, and other surgical procedures are usually used.
Other types of surgery for a blocked tear duct in babies or adults may include breaking a nasal bone, placing a tube in the tear duct, or surgically creating a new tear duct.
Surgery Choices
Surgical options for a blocked tear duct include:
- Probing, which involves passing a thin wire through the blocked tear duct to open it. Probing successfully opens the duct in about 90 out of 100 babies who have blocked ducts.1
- Intubation, which involves placing a silicone tube through the tear duct to maintain a passageway for tears to drain into the nostril. This may be done if the duct has excessive scarring or if it is difficult to pass the probe through the duct. Intubation may also be needed if probing is being repeated because a previous probing failed to open the tear duct.
- Infracturing, in which a nasal bone deep within the nose is broken to create an open duct and improve a passageway into the nostril. Infracturing will not permanently affect the size or shape of a baby's nose.
- Balloon dacryocystoplasty, in which a tiny balloon at the end of a probe is used to open the tear duct.
Surgical options that are rarely used for children—and only after the above procedures have failed—include:
- Dacryocystorhinostomy (say "DAK-ree-oh-SIS-toh-ry-NAW-stuh-mee"), which creates a new tear duct canal.
- Endoscopic and laser dacryocystorhinostomy. This procedure creates a new tear duct by using a lighted instrument and passing a flexible tube with a tiny camera on the end (endoscope) into the nostril.
When you talk about surgery options with your child's doctor, use this surgery information form (What is a PDF document?) .
In adults, treatment for a blocked tear duct depends on the cause of the blockage and can include any of the above choices.
What To Think About
About 6 weeks after a surgical treatment, you or your child will most likely visit the doctor for an eye exam and may be tested again with the fluorescein dye disappearance test.
| Last updated: | April 11, 2008 |
|---|---|
| Author: | Debby Golonka, MPH |
| Reviewed By: | Kathleen Romito, MD - Family Medicine, Christopher J. Rudnisky, MD, FRCSC - Ophthalmology |
| Editors: | Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC |
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