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Causes
By Mayo Clinic staff
Most of your tears come from your lacrimal glands, which are located above each eye. The tears flow down the surface of your eye to lubricate and protect it, and then drain into tiny holes (puncta) in the corners of your upper and lower eyelids. The tears then travel through the small canals in the lids (canaliculi) to a sac where the lids are attached to the side of the nose (lacrimal sac), then down a duct (the nasolacrimal duct) before emptying into your nose, where they evaporate or are reabsorbed. A blockage can occur at any point in the tear drainage system, from the puncta to your nose. When that happens, your tears don't drain properly, giving you watery eyes and increasing your risk of eye infections and inflammation.
Blocked tear ducts can be present at birth (congenital) or can occur at any other age. Causes include:
- Congenital blockage. As many as 20 percent of all newborns have a blocked tear duct. In these instances, the tear drainage system may not be fully developed or there may be a duct abnormality. A thin tissue membrane often remains over the opening that empties into the nose (nasolacrimal duct) in congenitally blocked tear ducts. This usually opens spontaneously during the first or second month of life.
- Abnormal development of the skull and face (craniofacial abnormalities). The presence of craniofacial abnormalities, including those in certain disorders such as Down syndrome, increases the likelihood of blockage of the tear ducts.
- Age-related changes. Older adults may experience age-related changes that can cause blocked tear ducts, including narrowing of the punctal openings.
- Eye infections or inflammation. Chronic infections and inflammation of your eyes, tear drainage system or nose can cause your tear ducts to become blocked.
- Facial injuries or trauma. An injury to your face can cause bone damage near the drainage system and disrupt the normal flow of tears through the ducts.
- Tumors. Nasal, sinus or lacrimal sac tumors can occur along the tear drainage system, blocking it as they grow larger.
- Cysts or stones. Sometimes, cysts and stones form in the tear drainage system, creating blockages.
- Topical medications. Rarely, long-term use of certain topical medications, such as those that treat glaucoma, can cause a blocked tear duct.
- Other medications. A blocked tear duct is a possible side effect of docetaxel (Taxotere), a commonly used chemotherapy medication for breast or lung cancer.
- Dacryostenosis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec09/ch100/ch100g.html#sec09-ch100-ch100d-200l. Accessed Aug. 23, 2010.
- Paysse EA, et al. Nasolacrimal duct obstruction (dacryostenosis). http://www.uptodate.com/home/index.html. Accessed Aug. 23, 2010.
- Casady DR, et al. Stepwise treatment paradigm for congenital nasolacrimal duct obstruction. Ophthalmic Plastic and Reconstructive Surgery. 2006;22:243.
- Mills DM, et al. Acquired nasolacrimal duct obstruction. Otolaryngology Clinics of North America. 2006;39:979.
- Kapadia MK, et al. Evaluation and management of congenital nasolacrimal duct obstruction. Otolaryngology Clinics of North America. 2006;39:959.
- Hurwitz JJ. The Lacrimal drainage system. In: Yanoff M, et al. Ophthalmology. 3rd ed. Philadelphia, Pa.: Mosby Inc.; 2008. http://www.mdconsult.com/das/book/body/215591989-11/0/1869/585.html?tocnode=56526590&fromURL=585.html#4-u1.0-B978-0-323-04332-8..00244-4_5653. Accessed Aug. 20, 2010.
- Emaeli B, et al. Prospective study of incidence and severity of epiphora and canalicular stenosis in patients with metastatic breast cancer receiving docetaxel. Journal of Clinical Oncology. 2006;22:3619.
- Dantas RR. Lacrimal drainage system obstruction. Seminars in Ophthalmology. 2010;25:98.
- Weiss AH. Conjunctivitis beyond the neonatal period. In: Long SS, et al. Principles and Practice of Pediatric Infectious Diseases. 3rd ed. Philadelphia, Pa.: Churchill Livingstone; 2008. http://www.mdconsult.com/das/book/body/215591989-9/1041841990/1679/89.html#4-u1.0-B978-0-443-06687-0..50088-6--cesec20_1773. Accessed Aug. 20, 2010.
- Becelli R, et al. Posttraumatic obstruction of lacrimal pathways: A retrospective analysis of 58 consecutive naso-orbitoethmoid fractures. Journal of Craniofacial Surgery. 2004;15:29.
- Robertson DM (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 30, 2010.
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