Tear Glands & Ducts Surgery
William L. White, MD
Tear Duct Problems and Surgery
The tear outflow tract starts with two small openings called puncta that are in the inner portion of you upper and lower eyelids. Each of these openings leads into a small tube call the canaliculus which in turn empties into the lacrimal sac, which is between the inside corner of your eye and nose. The lacrimal sac narrows into a tunnel called the nasolacrimal duct that passes through the bony structures surrounding your nose and then empties tears into your nasal cavity.
When you blink, your eyelids push tears evenly across the eyes to keep them moist and healthy. Blinking also pumps your old tears into the tear outflow tract, where they travel through the nasolacrimal duct and drain into your nose.
The most common symptoms of tear duct problems include mucous buildup at the inside corner of the eye and/or along the lashes, excessive watering and distorted vision. Depending on where along the passageway from the punctum to the nose the blockage occurs, you may also have redness, tenderness, infection, and swelling between the inner corner of the eye and the side of the nose.
Your surgeon may recommend a number of treatments based on the analysis of your symptoms with surgery being necessary for correction. Several different procedures are employed based upon the site and cause of the obstruction. Sometimes the native tract can be dilated with a balloon, which is called dacryocystoplasty. Other times a completely new tract into the nose needs to be made, which is called dacryocystorhinostomy. Pretty much all tear duct surgery is done as an outpatient.