Child Tear Duct Blockage Surgery

Child Tear Duct Blockage surgery is a procedure performed to address the common issue of blocked tear ducts in infants. Up to 10% of newborn experience this condition due to a membrane at the end of the nasolacrimal duct on the side of the nose, which prevents proper drainage of tears. Usually, the most common symptoms appear between 2 to 6 weeks after birth.

Initially, in the first month after birth, babies with this condition may reflect the secretion of tears or are not observed when the baby cries, and if tears come, it is most likely pathological (caused by a disease). Additional symptoms of the disease are discharge, inflammation of the conjunctiva, and infection of the lacrimal sac, in which case the area under the eyes, myopia, redness and inflamed as well as being sensitive to touch. This area may be swollen and mucous discharge can be seen on the inner side of the eye. In one third of the cases, this condition is bilateral and affects both eyes. Usually, sensitivity to the light is not typically observed, but the baby’s symptoms are aggravated by dust and wind.

In cases of excessive tearing and light sensitivity in the children, it’s important to also consider congenital glaucoma as a potential diagnosis. While congenital blockage of the lacrimal duct often resolves on its own, intervention may be necessary. Non-surgical and surgical methods are available for treatment. It’s worth noting that in about 95% of cases, the tear duct naturally opens before the child reaches one year of age.

1. . Conservative Treatment (Non-Surgical): Initial treatment involves periodic examinations, lacrimal sac massage, and the application of local antibiotics. To perform lacrimal sac massage, ensure your hands are clean, place your index finger on the inner side of the eye (towards the nose), and apply gentle pressure. In some cases, warm compresses are recommended. If there is an infection, the use of topical antibiotic ointments or drops may be advised. However, it’s important to note that antibiotics do not eliminate the obstruction. If the tear duct obstruction persists after several months of these treatments, probing surgery may be necessary. This procedure is successful in approximately 90% of cases for children under one year of age. Success rates tend to decrease as the child gets older.
2. Probing Operation: This surgical procedure, lasting about 10 minutes, involves inserting a thin metal probe through the closed tear duct to open the blockage. The optimal time for this operation is before the child reaches one year of age.
3. Balloon Dacryoplasty: This is a newer surgical technique where a balloon is placed in the corner of the eye and within the tear duct. At first, the balloon is inflated with a sterile liquid for 90 seconds, and then the liquid is removed, and the balloon is inflated again for 60 seconds before final deflation. The success rate of this method ranges between 80 and 100 percent.
4. DCR (Dacryocystorhinostomy): In rare cases where children still continue to experience tearing despite the aforementioned treatment measures, DCR, or Dacryocystorhinostomy is performed, similar to the procedure carried out in adults.