Newborn babies are sometimes born with a blocked tear duct. The condition, called dacryostenosis, occurs when a tear duct remains covered by a membrane after birth. Often, the obstruction opens within the first few months of life without further treatment. However, when the tear duct remains closed, or becomes blocked during adulthood because of chronic infection, inflammation or injury to the eye, there are ways to treat the condition.
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Massaging the Affected Area
Infants with continued tear duct blockage may respond well to the area being massaged several times a day for a few months. Place an index finger on the side of the child's nose and firmly massage down toward the corner of the eye. The application of a warm compress to the eye may ease discomfort while encouraging drainage. Massage alone may open the tear duct if performed regularly.
Tear Duct Probing
Blocked tear ducts that remain closed for longer than six to eight months after birth, or cause serious or repeated infections, may require the surgical procedure called probing to open the tear duct. Before the procedure, a local anaesthesia will be administered. During surgery, an ophthalmologist will use a thin, blunt metal wire to gently pass through the tear duct to clear the obstruction. Afterward, sterile saline will be flushed through the duct and into the nose to assess the open pathway. The patient will feel little discomfort after the procedure.
Silicone Tube Intubation
For children with prolonged tear duct blockage, doctors will first administer anaesthesia, and then insert silicone tubes into the tear ducts to stretch them. The tubes remain in place for up to six months, at which time the doctor will remove them during another short, in-office procedure.
Balloon Catheter Dilation
Balloon catheter dilation is a new procedure for children with a blocked tear duct. A doctor inserts a balloon through an opening in the corner of the eye and into the tear duct. Once the balloon is in place, it is inflated for 90 seconds with a sterile solution to expand the tear duct. It is then deflated and re-inflated for 60 seconds. It is then repositioned a little higher in the duct and inflated and deflated twice more before the balloon is finally removed. Anaesthesia is used for this procedure.
Adults with persistent chronic eye infections may get a blocked tear duct. When this occurs, a doctor might prescribe antibiotic medicine to treat the infection and correct the obstruction.
When no other treatment has been effective for older children and adults, surgery may be required to reconstruct the passageway and allow tears to drain out through the nose normally. After anaesthesia is administered, the surgeon makes a cut on the skin over the tear sac and makes a small hole in the bone between the tear sac and nose. The tear sac is connected to the inside of the nose to create a new, drainage passageway. Stents or intubation tubes are placed in the new route for three to six months post-surgery to ensure healing. After surgery, the patient uses nasal decongestant spray and topical eye drops to prevent infection and reduce inflammation.
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