66 Nasolacrimal Duct Obsturction

Nasolacrimal duct obstruction

Nasolacrimal duct obstruction (NLDO) is a condition of a blocked tear duct, in which your tears can’t drain normally, leaving you with a watery eye. It can be a partial or complete obstruction.

In patients with NLDO, tears don’t drain properly, resulting in a watery eye and an increased risk for eye infections and inflammation.

Patients usually present with excessive tearing, mucus discharge, eye irritation, gummy eyelid or blurring of vision, sometimes even with painful swelling at the inner corner of the eye.

Some have a history of pressure on the lacrimal sac which causes mucus reflux from the punctum.

Tests used to diagnose a blocked tear duct include:

  • Dye disappearance test or tear drainage test
    • A drop of a dye called flourescein is placed on the surface of each eye.
    • If most of the dye still remains on the surface of the eye after 5 minutes, it is very likely that the cause is a blocked tear duct.
  • Lacrimal syringing 
Congenital dacryoestenosis. Increase of the tear meniscus of the right eye.
Swelling and tenderness at the right lacrimal sac level. Spread infection to the inferior eyelid producing a preseptal cellulitis.