My son was born with a blocked tear duct in his left eye. We were told to massage the area and it would probably open in time. We have done this. He is now 10 months old and the tear duct is still closed. He rubs this eye sometimes, but so far has not had any real problems with it. We have been told we could have a procedure done on his tear duct to open it. It is called probing the tear duct. We have been told it is a simple procedure where he would be put under an anaestetic for approximately 10 minutes and they would run a probe into the tear duct to open it. How important is it that we have this procedure done now? Is there anything else that could be done to open the tear duct? We are concerned about him being anaesthetized at only 10 months and would like to know how safe this procedure is. We were also wondering if it is likely he could still outgrow this in time. Any information you could give us on this would be greatly appreciated. Thank you.
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Answered by Richard E. Gans, M. D. (xx152@ofcn.org)
Congenital obstuction of the tear duct is a common condition.
The tear duct normally drains the excess tears from the eye to the back of the nasal cavity. Infants are often born with a blockage of that tear duct just at the point where it enters the back of the nasal cavity. This leads to excess tearing and chronic, recurrent eye infections.
Massaging the tear duct is recommended for two reasons. Massaging increases the fluid pressure within the duct and can cause it to open. Massaging also helps drain the stagnant tears from the tear duct, thereby helping to prevent infections.
If massaging fails to alieviate the problem, a nasolacrimal duct probing is necessary. This is the procedure you described, where a probe is inserted through the tear duct to open the blocked passage. This is done in an operating room under a light anesthetic.
If the tear duct has not openned on its own by age six months, it is unlikely that it will open without intervention. The optimal timing of this procedure is when the child is between six months and two years of age. At this time, there is an 80% chance of permanently solving the problem. Success rate drops as the child gets older. If left untreated, tearing and recurrent infections will persist.
If the probing is unsuccessful, a second probing is performed with insertion of a fine silicone tube which stays within the tear duct for six weeks and is then removed. The success rate with the insertion of these tubes approaches 100%. Finally, if this fails, much more extensive surgery may be indicated.
Nasolacrimal duct probing is a very safe procedure. If care is taken, the risk of damaging the tear duct is minimal. There is a risk to the anesthetic. It is recommended that the anesthetic be administered by an anesthesiologist who is experienced in treating infants and children and in a facility that is equipped to deal with the special needs of children.
Copyright, 1995. Richard E. Gans, M.D.
A RICHARD E. GANS, M.D. 11
A A OFCN Primary Sysop, The Eye Clinic 111
AAAAA xx152@ofcn.org 11
A A A C A D E M Y O N E 1111
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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