Dr. Grace Lee, a plastic eye surgeon at Mass. Eye and Ear, talks about blocked tear ducts — a condition that’s surprisingly common in older adults.
Tears are important for your eyes to work correctly. They wash away dust and particles that get into the eye and help to keep the eye moist and healthy.
Normally, tears drain from the eye through tiny pores in the eyelids into tear ducts inside the nose. But if a tear duct gets blocked, it can cause watery eyes, with tears that stream down your face. In most cases, only one eye is affected. Other symptoms may include discharge from the eye and pain and swelling in the corner of the eye, which can be a sign of infection.
“Excessive tearing might not seem like a big deal, but it can really impair your quality of life,” said Grace Lee, MD, an eye plastic surgeon at Mass. Eye and Ear. “Watery eyes can make it difficult to see, especially while reading and driving. It’s also common to feel self-conscious or embarrassed about these symptoms.”
Dr. Lee adds that, most of the time, excessive tearing can be attributed to an overproduction of tears in response to a dry ocular surface, but it is important to see a specialist who can determine whether the problem is from overproduction, under-drainage — or a combination of both.
How does age affect your tear ducts?
Blocked tear ducts are especially common in infants, when tear ducts may not be fully developed yet. In most cases, the condition improves without treatment.
“But many people don’t realize that blocked tear ducts are also quite common after age 60,” said Dr. Lee. As we age, the small holes that drain tears can become obstructed or smaller, which slows the exit of tears into the nose, she explains.
Other common causes and risk factors
- Certain inflammatory diseases, such as sarcoidosis
- Tumors in the tear drainage system (nasal, lacrimal, sinus) such as lymphoma
- Injury to the bones or tissues around the eyes and/or nose
- Some cancer treatments (like radioactive iodine for thyroid conditions and certain chemotherapy drugs)
- Prior surgery in the nose, sinuses, or eyelids
When to see a doctor
If your eyes seem to be watering more than normal, tell your doctor.
“Many people assume it’s just a normal sign of aging that they need to live with,” said Dr. Lee. “But blocked tear ducts are actually very easy to diagnose and to treat.”
She also cautions that a blocked tear duct can lead to an infection. See your doctor right away if you develop a fever and experience redness, swelling and pain in the area between the eye and the nose.
Diagnosis and treatment
Your doctor will examine the inside of your nose to see if any structural problems are causing an obstruction. They may place a drop of a special dye on your eye to see if it drains or remains on the surface of the eye. They might also flush saline through your tear canal in the eyelid to see if the fluid drains properly into the nose and throat. And if needed, they may also use imaging tests to determine the location and cause of the blockage.
Treatment depends on the cause of the blockage, but most cases in adults can be fixed with surgery to widen or bypass the blocked duct. The outpatient procedure is performed under general anesthesia and typically takes 45 minutes or less.
“The recovery time is quick, and most patients are very satisfied with the results,” Dr. Lee said.
About our expert
Dr. Grace Lee is a plastic surgeon who specializes in conditions that affect the eyelids, eye socket and tear drainage system. She also treats trauma and tumors that affect the bones of the eye socket and surrounding tissue. She sees patients at Mass. Eye and Ear’s main campus (243 Charles Street, Boston), as well as in Malden (578 Main Street).