Blockage of the tear-drainage system can be congenital or acquired later in life. The condition may resolve over several months with mild treatment, but if infection occurs, surgery may be needed.

For the eye to stay healthy, it must remain moist. The lacrimal gland, located under the outer portion of the upper eyelid, helps to secrete tears.

During blinking, these tears wash across the eye and drain into small ducts on the nose side of the upper and lower eyelids. From here, the tears pass down the nasolacrimal duct into the nose.

Blockage of the tear drainage system may be seen anywhere from the eyelid ducts to the nose.

Symptoms include:

• Watering of the eye
• Accumulation of mucus
• Occasionally, infections in the lacrimal sac, seen as a red painful mass at the corner of the lids and nose

Congenital nasolacrimal duct obstructions are seen in about seven percent of newborns. In most cases, it is due to a membrane over the lower end of the tear drainage system. In most cases, this resolves over several months without specific treatment other than massage and topical antibiotics.

If the condition is not corrected within six months, the membrane may be perforated by a probing procedure that will cure the tearing in most cases. A second probing with placement of tiny silicone tubes is rarely needed. The tubes are removed after six months.

In acquired nasolacrimal duct obstruction, the duct slowly becomes narrowed from chronic inflammation from sinus disease or following trauma or nasal surgery. If tearing is the only symptom, no specific treatment is needed unless there is infection of the drainage system.

When symptoms are bothersome, surgery is required to create a bypass channel from the nasolacrimal system into the nose. This is performed under local or general anesthesia, and the success rate is about 90 to 95 percent.