Tear Duct Blockage

Specialists in North Texas

As parents, nothing is more important than the health and well-being of our children, and this includes their vision. Tear duct blockage, or nasolacrimal duct obstruction, is a common issue that can affect infants and children, causing uncomfortable symptoms and potential vision problems.

Expert Tear Duct Blockage Treatment in North Texas

At Pediatric Eye Specialists, we specialize in diagnosing and treating blocked tear ducts, ensuring that your child receives the best possible care.

Our team, the most experienced team of pediatric ophthalmologists in the North Texas region, is well-versed in the latest treatments for lacrimal obstructions. Our goal is to provide straightforward, effective solutions to restore proper tear drainage and protect your child’s vision.

We are committed to a clear and direct approach to care. We focus on efficient, comprehensive treatment plans tailored to your child’s needs. Trust Pediatric Eye Specialists to deliver expert care for your child’s tear duct blockage, setting them on a path to healthy vision now and in the future.

Dr. Norman with patient

The Basics: What is Tear Duct Blockage?

In the case of nasolacrimal duct obstruction, the normal flow of tears is blocked. This can occur at any point in the tear drainage system but most commonly happens at the nasolacrimal duct. For infants, this is often due to a congenital issue where the duct isn’t fully open at birth. In older children, blockages can result from chronic nasal inflammation, trauma, or, rarely, tumors. Proper tear drainage is vital. Without it, tears can accumulate, causing the eyes to become excessively watery, a condition known as epiphora. More seriously, stagnant tears can become a breeding ground for bacteria, leading to infections or inflammation of the surrounding tissue.

Why Pediatric Eye Specialists for Tear Duct Blockage?

The Most Experienced Team in North Texas

With over sixty-five years of collective pediatric ophthalmology expertise, we offer your child unparalleled collaborative care.

Four Convenient Locations

Easily accessible care with offices in Fort Worth, Denton, Southlake, and Mansfield, with expansion into Prosper in the near future. 

Unrushed, Clear Communication

We take the time to discuss your child's diagnosis and treatment, ensuring all your questions are answered to ease your concerns.

Affiliated with Cook Children’s Hospital

Our partnership with Cook Children’s Hospital means if your child needs surgery, imaging, or other specialists, they will be treated in one of the nation’s leading pediatric hospitals.

Specialized Expertise

Our expertise means that more optometrists, doctors, and specialists refer their pediatric eye patients to Pediatric Eye Specialists than any other pediatric eye practice in North Texas. 

Child and Family Focused​

Kids love us, and we love kids! We provide a caring environment for your child and your family.

Advanced Diagnostic Technology

We have the most comprehensive pediatric diagnostic suite in North Texas, allowing for precise diagnosis and highly personalized treatment plans. 

Every Child Needs Access to Expert Eye Care

Championing the right to sight, we help navigate insurance, cash pay, and Medicaid options to make superior eye care feasible for all children regardless of their socioeconomic status.

Dr. Packwood with patient

Benefits of Addressing Tear Duct Blockage

Addressing tear duct blockage early in children can significantly improve their quality of life and prevent long-term complications.

Success You Can Expect for Your Child

Prevention of Infection

Early treatment of blocked tear ducts can prevent the buildup of stagnant tears, which can become a breeding ground for bacteria and lead to recurrent eye infections. Addressing the blockage promptly reduces the risk of these infections and their associated complications.

Enhanced Comfort

Treating tear duct blockage alleviates symptoms like excessive tearing (epiphora) and mucus buildup, leading to increased comfort for your child. With proper tear drainage restored, your child can enjoy their daily activities without the irritation of constant tearing or discharge.

Better Vision

Clear tear drainage is essential for maintaining healthy eyes and supporting optimal visual development. Timely intervention ensures that the tear film remains healthy, which is crucial for clear vision. This helps prevent complications such as chronic eye irritation or blurred vision, which can affect a child's learning and overall visual experience.

Reduced Complications

Addressing blocked tear ducts early helps avoid further complications, such as dacryocystitis (infection of the tear sac) or more severe conditions like cellulitis. Early treatment options, including massage or probing, can significantly reduce these risks and provide long-term relief.

Emotional Well-Being

Resolving tear duct issues not only improves physical health but also boosts your child's confidence and emotional well-being. Children who experience chronic eye problems may become frustrated or self-conscious, particularly in social or educational settings. Effective treatment restores their comfort and confidence, enhancing their overall quality of life.

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Causes of Tear Duct Blockage

Blocked tear ducts in children, particularly conditions like nasolacrimal duct obstruction (NLDO), can arise from various sources. Understanding these causes is key to effective treatment and management.

Congenital Factors

Many tear duct blockages are congenital, meaning they are present from birth. Conditions such as congenital nasolacrimal duct obstruction occur due to the incomplete development of the nasolacrimal system. In some cases, the duct may not be fully open or can be blocked by a thin membrane at the distal end, known as the valve of Hasner. Many congenital nasolacrimal duct obstructions will resolve as the child grows. We will discuss with you and your family when it is appropriate to consider waiting for further growth and when treatment should be considered.


Some infants and children may be susceptible to infections that can affect the lacrimal system. Infections of the nasolacrimal sac, such as dacryocystitis (an infection of the lacrimal sac), although more common in adults, can occasionally occur in children and lead to blocked tear ducts.

Anatomical Variations

Anomalies in the anatomy of the lacrimal apparatus, such as narrow ducts or abnormal development of lacrimal puncta, canaliculi, or the lacrimal sac, can impede tear flow. These variations can lead to tear retention and subsequent problems.


In older children, trauma to the face or nose can cause damage to the nasolacrimal duct, leading to blockage. This can occur from accidents, falls, or injuries.

Chronic Nasal Inflammation

Chronic conditions that cause nasal inflammation, such as sinusitis or allergies, can contribute to the development of blocked tear ducts. Inflammation can cause swelling in the nasal passages, which can compress or obstruct the nasolacrimal duct.


Although rare, tumors in the nasal or orbital area can block the tear drainage system. These require prompt medical evaluation and treatment.

Foreign Objects

Occasionally, foreign bodies or debris can enter the tear drainage system and cause blockages. This is more common in toddlers who might accidentally insert objects into their nose.

Understanding these causes is vital for Pediatric Eye Specialists in diagnosing and formulating an effective treatment plan for blocked tear ducts. 

Signs and Symptoms of Blocked Tear Ducts

Identifying the symptoms of blocked tear ducts is critical to seeking timely treatment and preventing further complications. Here are the key symptoms parents should be aware of:

Persistent Tearing (Epiphora)

The most prominent sign of a blocked tear duct is continuous tearing. Despite the absence of crying or emotional distress, tears may overflow onto the cheeks.

Mucus Buildup

Blocked tear ducts can lead to an accumulation of mucus or pus in the eye, particularly noticeable after sleep. This can result in a sticky residue on the eyelids and lashes.

Recurrent Eye Infections

The stagnation of tears can result in recurrent eye infections, where the white part of the eye may appear red and inflamed, often accompanied by discomfort.

Swelling Near the Eye

The area around the nose and under the eye may be swollen, especially if an infection is present.

Blurred Vision

Excessive tearing and mucus can temporarily blur vision until the eye is cleared.

Irritation and Discomfort

Discomfort from a blocked tear duct may cause children to be fussy or irritable, particularly when you wash their eyes in the bath or clean them with a cloth. 

Behavior Problems and Fussiness

Discomfort from a blocked tear duct may cause children to be fussy or irritable, particularly during routine eye cleanings.

The symptoms of blocked tear ducts can be exacerbated by environmental factors. In cold or windy weather, the body produces more tears to protect the eyes, which can highlight the blockage when these additional tears cannot drain properly. During emotional moments, increased tear production can similarly overflow, making the blockage more apparent.

Have Concerns?

By recognizing these symptoms early, parents can take action to address blocked tear ducts before infections become frequent or the child experiences significant discomfort. At Pediatric Eye Specialists, we are equipped to diagnose and treat these symptoms, providing relief and preserving your child’s eye health. If you suspect your child might have blocked tear ducts, schedule your consultation. We are here to help and provide answers.

Diagnosing Blocked Tear Ducts

Prompt recognition and diagnosis of a blocked tear duct are essential steps toward ensuring your child’s ocular health and comfort. At Pediatric Eye Specialists, we emphasize the need for early intervention. Here’s what you can expect during the diagnostic process:

Initial Consultation and Physical Examination

Upon your visit, we conduct a comprehensive assessment of your child’s symptoms. Our pediatric ophthalmologists will perform a thorough physical examination of your child’s eyes, focusing on areas such as:

  • Eyelid Examination: We assess the eyelids to check for swelling, redness, or discharge.

  • Punctal Evaluation: The puncta, or tiny openings on the lid margins, are inspected to ensure they are not narrowed or blocked.

  • Lacrimal Sac Assessment: Gentle pressure may be applied to the lacrimal sac area to observe if any fluid backs up into the eye, which can indicate a blockage.

Diagnostic Tests

Depending on the findings from the physical examination, we may proceed with diagnostic tests to confirm the diagnosis:

  • Dye Disappearance Test: A harmless dye is placed in the eye, and its drainage is observed. Delayed clearance of the dye suggests a blocked duct.

  • Tear Duct Imaging: In certain cases, imaging tests such as a dacryocystogram, which involves taking X-rays of the tear ducts after a special dye is introduced, can provide detailed insight into the location and extent of the blockage. This imaging modality is rarely used as the signs and symptoms of the child are usually enough to diagnose the condition.

Understanding and acting upon the signs of a blocked tear duct can prevent complications, such as chronic infections, and ensure your child’s eyes remain healthy. If you’ve noticed persistent symptoms like excessive tearing or recurrent eye infections in your child, it’s time to seek expert care.

At Pediatric Eye Specialists, we’re committed to providing timely, accurate diagnoses with a child-friendly approach. Our advanced diagnostic capabilities and our dedicated team’s expertise allow us to identify and treat blocked tear ducts effectively, ensuring your child receives the best possible care from the start.

Blocked Tear Duct Treatments: A Path to Relief

When it comes to treating blocked tear ducts in children, Pediatric Eye Specialists offers a spectrum of options tailored to the individual needs of our young patients. Our approach is methodical, beginning with the least invasive methods and progressing to more advanced treatments as necessary. Here’s an overview of the treatments available:

Conservative Management

For less severe cases or as initial treatment steps, we often recommend conservative approaches:

  • Massage Therapy: As a first line of treatment, especially for infants, we often recommend a gentle massage technique known as “crigler massage.” This method helps to open up a partially blocked duct and facilitate natural tear drainage. We provide parents with clear instructions on how to perform this massage safely and effectively at home.

  • Antibiotics or Combination eyedrops: If infection is present, we may prescribe antibiotic eye drops or ointments or an antibiotic/steroid combination drop. These are used to clear up any infection that may be exacerbating the blockage.

  • Warm Compresses and Eyelid Scrubs: Applying warm compresses and using baby shampoo to clean the eyelashes can provide relief from discomfort. Despite the appearance of the eyelashes, many child are not strongly symptomatic if the crusting and mucus can be cleaned from the lashes.
  • Time: Most children just need time to grow. If your child is less than 6 months, statistically speaking your child should grow out of a blocked tear duct. After your child is around 9 months of age, if the condition is still present, the changes of growth resolving the issue decrease dramatically.

Surgical Interventions

For cases where conservative treatments are insufficient, we consider surgical options:

  • Probing: A common and highly successful procedure for treating nasolacrimal duct obstruction is probing. This is done with topical anesthesia in the office setting for patients between the ages of 6 and 12 months. If they over one year of age, the procedure is done under general anesthesia to ensure the child’s comfort, a thin probe is inserted into the tear duct to clear the blockage. This straightforward procedure can often provide immediate relief. If done with anesthesia, a silicone stent is often used to ensure the duct remains open. The stent is removed in the office a few months later. Removal does not require anesthesia.

  • Balloon Catheter Dilation: In more complex cases, balloon catheter dilation under general anesthesia can be used to widen the ducts and allow for normal tear drainage. This minimally invasive procedure has shown excellent results in improving tear flow.

  • Dacryocystorhinostomy (DCR): For persistent blockages, DCR surgery may be performed. This involves creating a new passageway for tears to bypass the blocked area of the duct. DCR can be conducted using traditional or endoscopic methods, depending on the specific case and anatomical considerations.

  • Anesthesia Care: Our pediatric anesthesiologists specialize in caring for children and are adept at managing the nuances of anesthesia in young patients, ensuring a safe and comfortable experience.

Post-Operative Treatment

  • Eye Drops: After surgical procedures, we typically prescribe eye drops to prevent infection, reduce inflammation, and promote healing. We provide detailed instructions on how to administer these drops to your child.

  • Follow-Up: Postoperative care is crucial. We schedule follow-up visits to monitor the healing process, evaluate the success of the treatment, and ensure that the tear duct remains open.


Addressing Tear Duct Blockage in Infants

Infants often present with tear duct blockage. Due to the delicate nature of an infant’s developing tear duct system, we want to watch your child to see if he or she outgrows their issue at around 9 months, while treating your infant with non-invasive means while we do active survelliance of their condition. 

Each step of our treatment plan is designed with the ultimate goal of alleviating symptoms, restoring function, and improving your child’s quality of life. At Pediatric Eye Specialists, we combine advanced medical treatments with compassionate care to provide the best outcomes for your child’s eye health.

Typical Expected Outcomes for Tear Duct Blockages

At Pediatric Eye Specialists, our approach to treating blocked tear ducts is rooted in evidence-based medicine and years of specialized practice. When discussing the expected outcomes of treatment, we provide parents with realistic expectations based on a thorough assessment of their child’s condition and the response to similar cases in the past.

Success Rates of Treatment

Procedures such as probing for nasolacrimal duct obstruction are generally quite successful, particularly in infants and young children. The majority of patients who undergo this treatment experience a significant improvement in symptoms, with many resolving the issue entirely. It’s important to note, however, that as with any medical procedure, individual outcomes can vary based on a variety of factors, including the child’s overall health and the specifics of their condition.

Postsurgical Recovery

For those requiring surgical interventions, we anticipate a gradual improvement in symptoms as the child recovers. Our surgical techniques are designed to minimize discomfort and expedite recovery time, and we provide comprehensive postoperative care to support healing.

Nonsurgical Management

For children managed with conservative treatments like tear duct massage and antibiotics for associated infections, we typically see a reduction in symptoms like excessive tearing and discharge. These methods can be quite effective, especially when the blockage is partial or in younger children where spontaneous resolution as they grow is more common.

Secure a Brighter Future: Schedule Your Child's Blocked Tear Duct Consultation Today

At Pediatric Eye Specialists, we understand the importance of your child’s eye health and the trust you place in us for their care. If your child is experiencing symptoms of a blocked tear duct, don’t wait for them to worsen. Take the first step toward clear and comfortable vision for your child.

Contact us today to schedule an appointment. Our team of compassionate experts is here to provide the best care, from diagnosis to treatment and beyond. Let us guide you and your child back to a world of bright and healthy vision.

Doctor and Patient

Start your child’s journey to better vision today.

Embrace a future of clearer vision and confidence for your child. Contact us now to book your consultation at any of our convenient locations across the Metroplex.

At what age do blocked tear ducts typically become noticeable in children?

Blocked tear ducts are most commonly noticed in infants, often within the first few weeks to months of life. This condition can be present from birth, and parents might observe symptoms such as constant tearing or discharge from one or both eyes.

Are there any specific activities or environmental factors I should avoid to prevent worsening my child’s blocked tear duct?

While environmental factors don’t cause blocked tear ducts, certain conditions can exacerbate symptoms. Try to keep your child’s eye area clean and avoid irritants like smoke or dust. Also, be cautious in windy or extremely cold environments, as these can increase tear production, which may be uncomfortable for a child with a blocked duct.

How can I distinguish between normal tearing and a blocked tear duct in my baby?

Normal tearing is usually in response to irritants or emotions and is temporary. With a blocked tear duct, you’ll notice consistent tearing or mucus buildup, regardless of the baby’s emotional state or environment. This excessive tearing often results in wet eyelashes or cheeks, even when the baby is not crying.

What should I do if I notice signs of a blocked tear duct in my older child who didn’t have these symptoms as an infant?

If symptoms of a blocked tear duct appear in an older child, it’s important to schedule an appointment with an ophthalmologist. Blocked tear ducts in older children can result from other underlying issues like trauma, infection, or nasal problems, which require professional evaluation.

Can allergies contribute to tear duct blockage in my child?

While allergies themselves don’t cause blocked tear ducts, they can lead to swelling and inflammation around the nasal passages and eyes, which might exacerbate the symptoms of an existing blockage. Managing your child’s allergies effectively can help minimize discomfort related to blocked tear ducts.

Is it possible for a child to develop a blocked tear duct later in childhood after having no issues as an infant?

Yes, it’s possible for children to develop blocked tear ducts later in childhood, even if they had no such issues as infants. Causes for late-onset blockages can include infections, nasal congestion, or trauma to the nose or eye area. If you notice symptoms of a blocked tear duct in your older child, seek an ophthalmologist’s evaluation.

What should I do if my child’s blocked tear duct symptoms don’t improve, despite home treatment?

It’s important to consult with your health care provider if symptoms persist. They may refer you to an ophthalmologist for specialized care. Persistent symptoms may require further investigation to rule out other conditions or complications like dacryocystitis, an infection of the tear sac.

Could my child’s blocked tear duct be a birth defect, and how would it be treated?

Yes, some children are born with a condition known as congenital nasolacrimal duct atresia, where the tear duct system is not fully developed. It’s a common birth defect that can often resolve on its own, but if it doesn’t, treatment options are available and should be discussed with your pediatric ophthalmologist.

My child has developed a fever and swelling near the eyebrow area. Could this be related to their blocked tear duct?

Fever and swelling near the eyebrow could indicate an infection, potentially related to a blocked tear duct. The skin around the duct can become infected if the blockage causes tears to stagnate. Consult your health care provider promptly as these symptoms can also be associated with more serious conditions.

Are there any risks of bone injury or damage during treatments for a blocked tear duct?

In treatments like probing or surgery, there’s minimal risk to the bone structure, such as the lacrimal bone, which is adjacent to the tear ducts. These procedures are performed by experienced ophthalmologists who are trained to avoid injury to surrounding tissues and structures.

Can using a cotton swab to clean my baby’s face cause a blocked tear duct?

While gentle cleaning around the eyes with cotton is usually safe, it’s important to avoid applying pressure near the tear ducts with a finger or cotton swab, as this could potentially cause injury or introduce bacteria, leading to infections like dacryocystitis.

What is atresia, and how does it relate to my child’s blocked tear duct?

Atresia refers to a congenital absence or closure of a body orifice or passage, such as the nasolacrimal duct. If your child has nasolacrimal duct atresia, it means the duct that normally allows tears to drain from the eye to the nose did not develop properly, which can lead to tear duct blockage.


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