Tear Excretion System

The tear duct system consists of tear ducts, which open into two initial orifices on the inner side of the upper and lower eyelids, the tear sac, and a thin tear duct. This system terminates by opening into the nasal cavity. Tears regularly wash and lubricate our eyes through blinking, enabling clear vision. Harmful substances in front of the eye are removed by tears through the tear duct.

Congenital tear duct obstructions

In infants born with tear duct problems, tearing and discharge in the eyes can occur because the opening of the tear drainage system into the nose fails to open after birth. Depending on the baby’s age, the severity of the symptoms, and the specific signs, different treatment methods may be necessary, such as massage, probing, silicone tube intubation, and dacryocystorhinostomy.

Up to the age of one, the tear sac area should be massaged as shown by your doctor. Generally, it opens with massage until the age of one.

If the tear duct doesn’t open, a probing procedure is performed. Some children may have excessive discharge and tearing, and swelling and infection may occur in the tear duct. In these children, probing can be done even before the age of 1. The probing procedure is performed in an operating room under general anesthesia and takes approximately 5-10 minutes. A probe is inserted through the upper end of the tear duct, and the blockage at the lower end where the duct opens into the nose is cleared. When performed in time, the success rate of probing is around 90-95%. The success rate of probing decreases in babies over 2 years old.

In infants whose tubes do not open with probing, silicone tube intubation can be performed.

If the child consults a doctor after going through these stages, a dacryocystorhinostomy operation becomes necessary.

Dacryocystorhinostomy

The blocked portion of the tear duct is bypassed, creating a new channel between the tear sac and the nose. Sometimes, a silicone tube may be placed in the channel during DSR surgery. This tube is removed after 3-6 months. The child should avoid scratching the surgical area.

Emine ŞEN , O. Konuk, M. Ünal. Bicanalicular Silicone Intubation in the Treatment of Congenital Nasolacrimal Duct Obstruction. MN Ophthalmology 17(1); 31-37, 2010.

Emine ŞEN, O. Konuk, M. Ünal. Results of bicanalicular silicone intubation technique in the treatment of congenital NLK obstruction. TOD 43rd National Congress, November 11-15, 2009/Antalya (Congress Booklet, page 180)