Nasolacrimal Duct (Tear Duct) Anomalies

What Are Nasolacrimal Duct Anomalies?

Nasolacrimal duct anomalies are problems with tear duct development that many babies are born with. Tear ducts are tiny tubes near the inner corner of the eyes that carry tears from the surface of the eye into the nose to drain.

Blocked tear ducts are common, and many cases improve without treatment within a year. Other tear duct anomalies are more serious and cause long-term blockage and infection that can spread to the eye.

What Causes Nasolacrimal Duct Anomalies?

The main cause of nasolacrimal duct anomalies is some type of obstruction, including:

  • A membrane at the end of the tear duct that does not open, around birth
  • Missing parts of the lacrimal system, from the punctum (opening at the lid) to the canaliculus (small duct that connects to the lacrimal sac) to the tear duct itself  
  •  Bony blockage of the tear duct

Symptoms of Nasolacrimal Duct Anomalies

Newborns usually show symptoms of nasolacrimal duct anomalies within a few weeks of birth. These include:

  • Eyes that tear (water) constantly
  • Red, swollen eyelids that may develop a crust
  • Yellowish-green discharge

How Are Nasolacrimal Duct Anomalies Diagnosed?

Often, your baby’s pediatrician will be able to diagnose nasolacrimal duct anomalies and, if needed, will refer to an ophthalmologist for proper management.

Treatments for Nasolacrimal Duct Anomalies

Nasolacrimal duct anomalies often clear up without surgical treatment, in the first 6-to-8 months of age. When treatment is necessary, the options we recommend at Children’s National include:

  • Gentle cleaning of any discharge from the eyes with a warm, wet washcloth
  • Massaging of the tear ducts to help expressing the infection/discharge out
  • Antibiotic eye drops or ointment to prevent or treat infection
  • Surgery to open the tear ducts if the condition persists

Learn more about our Ophthalmology program at Children’s National.

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Our specialized pediatric ophthalmologists are experts at recognizing and treating complex eye conditions in infants and children.

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