Dacryostenosis, often called lacrimal duct obstruction, is a common problem in newborns, although it can also affect adults. This condition occurs when the nasolacrimal duct, which connects the eye to the nasal cavity, becomes blocked, preventing tears from flowing normally.
What causes dacryostenosis?
Dacryostenosis is often congenital, i.e., present from birth. It occurs when the nasolacrimal duct is not completely open or remains obstructed by a thin membrane that has not dissolved. This type of dacryostenosis affects around 5% of newborns, although most improve naturally in the first few months of life.
In adults, dacryostenosis can occur as a result of a variety of factors, including:
- Repeated infections of the lacrimal duct causing inflammation and scarring.
- Ocular or facial trauma that damaged the tear duct.
- Hormonal changes and aging which can thicken the canal walls.
- Anatomical problems or abnormal development of the tear ducts.
Main symptoms of dacryostenosis
The most common symptom of dacryostenosis is excessive tearing, also known as epiphora. In babies and adults, the following may be observed:
- A constant flow of tears, often accompanied by mucous or purulent secretions, especially if an infection is present.
- Redness or inflammation of the eyelid.
- Eyelid crusting, especially on waking.
- Increased sensitivity to light and frequent episodes of eye irritation.
What are the treatment options?
Treatments vary according to the patient's age and the severity of the obstruction.
Treatments for infants
- Tear sac massage: When performed correctly, this gentle method can encourage the natural opening of the nasolacrimal duct in newborns. It is often performed several times a day.
- Antibiotic eye drops: If an infection develops, the doctor may prescribe eye drops to reduce inflammation.
- Tear catheter: If the tear duct remains obstructed after several months, a minor surgical procedure involving the insertion of a catheter into the duct may be performed.
Treatments for adults
- Tear flushing: The healthcare professional may flush with a saline solution to clear the duct and relieve symptoms.
- Dilatation surgery: When the obstruction is severe, a procedure to open the duct, called dacryocystorhinostomy (DCR), is often recommended. This involves creating a new connection between the lacrimal sac and the nasal cavity.
- Stents and tubes: In some cases, temporary tubes are inserted to keep the nasal passage open.
When to seek medical advice
If symptoms of dacryostenosis persist or worsen, it's essential to consult an Optometrist. An untreated obstruction can lead to chronic infections and serious ocular complications. Early diagnosis and appropriate treatment usually guarantee a rapid and effective resolution.
Dacryostenosis can cause significant discomfort but is very treatable when managed promptly. Whether for infants or adults, advances in treatment techniques are delivering effective results and lasting symptom relief.
