What is Dacryostenosis?
Dacryostenosis or nasolacrimal duct obstruction (NLDO), is inflammation of the nasolacrimal duct (tear sac), mainly due to poor tear drainage.¹ Dacryostenosis can be congenital, idiopathic or acquired.
Often referred to as a blocked tear duct, dacryostenosis causes excess tearing and yellow discharge in the eye.² It is generally treated with a warm compress but can require surgery or other medical interventions if dacryostenosis is due to underlying issues.²
Key Takeaways
- Dacryostenosis occurs because of poor drainage of the tear ducts.
- Dacryostenosis can be congenital (occurs in infants), idiopathic (no known cause) or acquired in adulthood due to other diseases, injuries or medications.
- Treating dacryostenosis typically involves a warm compress and manual expression of the ducts through light massage. Some chronic cases require surgery to expand the ducts.
Understanding Dacryostenosis
Dacryostenosis is a condition of the nasolacrimal duct, part of the lacrimal gland system.³ Often, the cause of dacryostenosis is unknown (idiopathic).³ Adults can acquire dacryostenosis from other diseases, trauma or chemotherapy, and radiation.³ Some researchers suggest that a narrow lacrimal duct or infection in the conjunctiva can lead to dacryostenosis.³
Dacryostenosis in infants is referred to as congenital dacryostenosis.⁴ Lack of nasolacrimal duct development leads to congenital dacryostenosis.⁴ Symptoms often develop after two weeks of age and resolve by 6-9 months old.⁴
Treatment Options for Dacryostenosis
Depending on the underlying cause, doctors may take different approaches to treat dacryostenosis.
In congenital dacryostenosis, caregivers can apply a warm compress and gentle massage to the infant’s lacrimal sac a few times per day to express the ducts.⁴ Caregivers should apply moderate pressure over the lacrimal sac in the corner of the eye in a downward direction.³
In rare cases, a blocked duct may lead to an eye infection, in which case a doctor may prescribe antibiotics.⁴ If a child is still experiencing clogged ducts after their first birthday, an eye doctor (ophthalmologist) may probe the duct to enlarge it and allow normal tear flow.⁴
For acquired dacryostenosis, doctors will typically try to treat the underlying cause (other diseases, injuries, or medications).² If that course of treatment is not possible or does not alleviate symptoms, an eye doctor can perform various surgeries, including dacryocystoplasty and dacryocystorhinostomy.³
Dacryocystoplasty is minimally invasive and uses a balloon to insert a stent to open the lacrimal duct.³ A dacryocystorhinostomy involves removing part of the lacrimal bone to create space between the lacrimal sac and the nasal cavity.³
