• Often in newborns the tear ducts are not completely open at birth or become blocked, causing tears to remain in the eyes.
• Physical abnormalities affecting the tear ducts, the tear sacs or the pathways through which tears travel.

In infants the most common symptoms of blocked tear ducts are excessive tearing and watery eyes without tears falling. Adults may find their eyes constantly tearing. In severe or chronic cases there may be frequent eye irritation since contaminants are not flushed out. Without treatment an infection may occur, causing pus, which can then affect the eyes and lead to a more severe problem or infection of the eye.

In infants, treatment may begin with parents massaging the tear ducts and in 80-90% of cases this is enough to resolve the problem. If blocked tear ducts continue during a baby’s first year of life, your doctor may choose to lance the blocked duct, which is successful in most children in permanently treating the problem. If not the doctor may thread a silicone tube through the tear drainage system and into the nose. If all methods above fail, surgery is the ultimate option.
 
In adults treatment for blocked ducts usually involves surgery and there are currently two methods that may be used:

1. Traditional surgery called ‘external dacryocystorhinostomy’ involves an incision from the outside of the eye, which leaves a scar.
2. A newer type of surgery called ‘endoscopic dacryocystorhinostomy’ is done with an endoscope inserted through the nose to create a new tear drainage system. No scar is visible through this method and recovery is quicker when compared with traditional surgery.

However, your doctor will decide on the best treatment option for each patient.