EXCESSIVE TEARING MAY SIGNAL BLOCKED TEAR DUCTS

KUALA LUMPUR, Jan 7 (Bernama) -- Obstructed tear ducts, a condition that blocks the eye’s natural drainage system, could affect people of all ages, with experts warning that low awareness often delays treatment, causing tears to overflow and, in some cases, leading to infections.

Sunway Medical Centre Velocity (SMCV) Consultant Ophthalmologist and Oculoplastic Surgeon Dr Nazila Ahmad Azli said the condition occurs when the drainage pathway from the eyelids to the nose becomes blocked, preventing tears from draining normally and causing them to back up and overflow onto the cheeks, a condition known as epiphora.

She explained that excessive tearing usually stems from two main causes, namely overproduction of tears and a blockage in the tear drainage system.

“One common cause is overproduction of tears due to irritation, infection, inflammation, allergies, or eye conditions such as facial nerve palsy.

“The other common cause is a blocked tear drainage system. When tears cannot drain normally, they overflow. Patients may also experience sticky discharge, and if the blockage is left untreated, the area may become infected,” she told Bernama recently.

Dr Nazila said that although there are no official national statistics in Malaysia, global data suggests that between 20 and 30 people per 100,000 population are affected by this condition.

She noted that the condition typically affects two groups, namely children and adults.

In children, this is usually congenital in origin and can affect infants up to three years of age. As for adults, this is usually acquired in life for various reasons.

“Adult cases can appear as early as the age of 20, but in my practice, they are more commonly seen between 40 and 70 years old,” she said, adding that women are more susceptible than men.

She explained that women generally have narrower tear drainage systems, and that menopausal hormonal changes, along with the higher prevalence of dry eyes, which can trigger inflammation and scarring, may further increase the risk of obstruction.

To diagnose obstructed tear ducts, Dr Nazila said an Oculoplastic Surgeon typically begins with a detailed medical history and a physical examination, assessing the pattern of tearing and examining the tear sac area at the inner corner of the eye. 

Additional tests, such as the dye disappearance test, may be conducted to observe how efficiently a coloured dye placed on the surface of the eye drains into the tear duct.

According to Dr Nazila, a clinic procedure such as lacrimal irrigation or syringing may also be performed, gently flushing the tear system with saline to determine the location and severity of the blockage. In more complex cases, or when a tumour is suspected, imaging tests such as dacryocystography or a CT scan may be used to visualise the duct and surrounding structures.

“Treatment depends on the severity of the condition and the patient’s age. For infants or mild cases, non-surgical approaches such as gentle massage of the tear sac are usually recommended, while probing and syringing or lacrimal stent placement may be carried out for infants if necessary. Approximately 90 per cent of infants have their symptoms resolved by one year of age.

“For persistent blockage in adults, the definitive treatment is dacryocystorhinostomy (DCR), a surgical procedure to create a new drainage channel. This can be performed externally through a small incision between the eye and the nose, or endoscopically via the nose using a camera. In most cases, a temporary silicone stent is placed to keep the newly created drainage channel open during healing,” she said.

Dr Nazila also stressed that early diagnosis and proper treatment are important to relieve symptoms and prevent complications such as recurrent infections or inflammation around the eye.

However, she cautioned that symptoms such as pain, swelling, redness, or blurred vision require prompt treatment to prevent complications such as orbital cellulitis, a serious inflammation of tissues behind the eye.

She also advised the public to maintain good eyelid hygiene, including doing regular warm compresses and using eyelid wipes, to reduce the risk of inflammation.

“If you develop symptoms that are unusual for you, seek help promptly. If left untreated, a blocked tear duct can lead to infection and more sinister complications,” she added.

-- BERNAMA

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