Ophthalmology Specialist Op. Dr. Mehmet Kay gave information about the symptoms and treatment of tear duct obstruction.
What is tear duct obstruction and how does it occur?
With the canal system between the eye and the nose, excess tears are transferred into the nasal cavity under normal conditions. As a result of obstructions in the tear sac or duct, which is the intermediate stop of this pathway, due to various reasons, the tears cannot reach the nose anymore and the patient experiences constant tearing.
What are the symptoms of tear duct obstruction and infection?
– Excessive eye watering
– Frequent burrs in the eye
-Inflammation of the eye by pressing on the root of the nose
– Swelling at the root of the nose
What happens if lacrimal duct obstruction is not treated?
If the lacrimal duct obstruction is not treated, the lacrimal sac and duct become filled with microbes. After a while, an abscess may develop in the lacrimal sac and this abscess may open to the skin. In addition, this infection in the lacrimal sac can spread to the eyes, skin and soft tissues and cause serious infections there.
The treatment is surgery. With the method we call DSR surgery, approximately 1 cm of incision is made from the skin and the lacrimal sac is reached. Then, a bone window is opened in the nose and a new path is created between the lacrimal sac and the nasal cavity. It may be necessary to put a silicone tube in order to prevent this path from being blocked afterwards. This tube stays in the eye for 3-6 months, then it is removed.
What is the cause and treatment of watery eyes in babies?
Although there are many causes of eye watering in infants, the most common of these is congenital tear duct obstruction. This is due to the inability of the membrane structure at the lower end of the tear duct to open. It usually manifests itself with eye watering and burrs 1-2 months after birth. It can happen in one or both eyes. Since tear production usually starts 2 months after birth, watering may not be seen in the first months. When the child wakes up in the morning, the eyelashes are sticky and burr.
In treatment, it is usually followed up to one year of age. During this period, the infection in the eye is combated. The burrs formed are cleaned by softening them with boiled warm water. Since it will be possible to open the canal spontaneously over time, it is appropriate to follow up without intervention until the age of 1 year. Up to the age of 1, massage therapy is recommended for an average of 4 times a day, 15 times a day. At the root of the nose, the lacrimal sac area should be deeply pressed with the tip of the finger and massaged. If the canal is not opened with all these treatments until the age of one, an operation called probing is performed.
In the probing procedure, the unopened membrane is opened with a wire inserted into the tear ducts under anesthesia. No incision is made in the surgery, it is painless and bloodless. After the operation, the eye is not closed, drops are used for 1 week. The success rate of probing is high in the first 3 years. The success rate decreases at older ages. In cases that cannot be opened with the first catheter, a second probing can be performed 2 months later, if it is not opened again, a tube is inserted into the tear ducts. The tube is removed after being left in place for 3 – 6 months. Since probing is not effective after the age of five, it is not generally applied and DCR surgery is applied in adults.