Blocked Tear Duct Treatment for children in Delhi 

What is a blocked tear duct?

A blocked tear duct occurs when the drainage system responsible for tears in the eye becomes obstructed, preventing tears from draining properly. This can result in watery, irritated, or chronically infected eyes.

In newborns, blocked tear ducts are quite common, affecting approximately 20% of them. However, most cases tend to resolve on their own within four to six months.

In adults, tear duct obstruction can be caused by factors such as eye infections, swelling, injury, or even tumors. Symptoms of this condition include watery eyes, redness, and the potential for eye infections.

The treatment options for blocked tear ducts include massage, dilation, probing, irrigation, stenting, and surgery. The specific choice of treatment depends on various factors such as the patient's age, the severity of the blockage, and other related considerations.

For infants, a special massage technique is often utilized to open the membrane and create a valve effect.

In older children and adults, dilation, probing, and irrigation are typically the initial methods employed for treatment. In more complex cases, a more advanced form of dilation or the insertion of a tube or stent may be required.

Surgery is an option for adults who have not responded well to other treatment approaches.

Blocked tear ducts can be caused by various risk factors such as age, chronic eye inflammation, previous surgery, glaucoma, and previous cancer treatment.

If left untreated, complications may arise, including frequent eye infections, inflammation, and potential damage to the tear duct system.

It is advisable to consult an ophthalmologist if you experience watery and leaking eyes, or if your eyes are constantly irritated or infected.

The symptoms of a blocked tear duct in Children

Symptoms of a blocked tear duct in children include:

• (Tears) pooling in the corner of the eye, draining down the eyelid, or running down the face
• Tears draining down the eyelid and cheek
• Dried crusting on the eyelashes
• (Redness)Redness of the white part of the eye, or redness or irritation of the eyes or eyelids from rubbing.
• (Discharge)A sticky white or yellow discharge that can get crusty, or mucus or a yellowish discharge in the eyes
• A swollen eyelid or near the eye tissues

What are the causes of the blocked tear duct in Children?

When tears cannot naturally drain, there is a blockage in the tear duct. A blocked tear duct can have several reasons, such as:

• Infection
• Neoplasm
• Injuries
• Nose trauma
• Cancer
• Nasal polyps
• Conjunctivitis
• Glaucoma
• Sinus problems
• Chronic eye inflammation
• Birth defect
• Narrow tear ducts
• Age
• Scar
• Pharmaceutical drug

Treatment of Blocked Tear Duct in Children     

Both babies and adults can benefit from the following methods when a blocked tear duct won't open on its own:

• Massage

Massaging the lacrimal sac, the area where tears exit the eye and enter the tear duct, is one of the simplest methods to clear a blockage in babies or adults.

Use a clean piece of cotton or your clean fingertips to gently touch your baby's bottom corners of eyes and nose for a few seconds. The corners of the eyes should start to drain a clear fluid as a result of this action.

The membrane covering the tear duct may burst open due to the pressure applied during the massage.

• Medicament to fight infection - Antibiotics

However, he or she may define antibiotic eye drops or capsules, If your consultant suspects that an infection is present. Antibiotics can treat an infection and get rid of any waste coming from the eye, but they won't open the obstruction.

• Wait and watch.

Not every person with a blocked tear duct requires medical treatment. The majority of babies with a blocked tear duct after birth recover by themselves without medical help. This might happen during the first several months after birth while the drainage system develops.

A thin tissue membrane often covers the hole that discharges into the nose. Still, his or her consultant may instruct you on a special strategy to help open the membrane, If your baby's blocked tear duct does not perfectly go.

Even so, your doctor could advise you to wait a few months to see whether things get better while your wound heals. If a face injury resulted in blocked tear ducts. Your tear ducts may open as the swelling disappears.

• Dilation, probing, and flushing.

When treating obstructed tear ducts in babies, dilatation, probing, and flushing are often used techniques. When using this procedure, general anesthesia is used. The tiny holes in the corner of the eye where tears drain are called punctal apertures, and the medical professional enlarges them using a specific dilation tool. 

To aid remove any obstructions, a tiny probe is then introduced into the puncta and the tear drainage system. An analogous treatment can be carried out in adults, especially in individuals with partially constricted puncta. Using a tiny probe, the healthcare professional may enlarge the puncta before irrigation—a technique that clears the tear duct—takes place. 

• Stenting or intubation.

Under general anesthesia, the stenting or intubation technique is frequently carried out. The procedure entails passing a thin silicone or polyurethane tube through one or both of the puncta, which are tiny holes in the corners of your eyelid.

After that, these tubes enter your nose through the tear drainage system. You will still be able to see a tiny loop of tubing in the corner of your eye.

These tubes are usually removed after three months. It's crucial to remember that there might be side effects from this surgery, such as inflammation brought on by the tube.

Adults with partly constricted puncta may benefit from irrigation therapy. During this process, your healthcare professional will use a tiny probe to enlarge the puncta before flushing the tear duct. This is a straightforward outpatient operation that frequently relieves the symptoms of a clogged tear duct, at least momentarily.

• Balloon catheter dilation.

One treatment used to treat blocked tear ducts, especially in children is balloon catheter dilatation. To widen the tear duct, a balloon at the end of a thin tube known as a catheter is inflated during the process. Next, the balloon is taken down and deflated.

This process, which is usually carried out under general anesthesia, is efficient in clearing the obstruction and offers at least momentary relief.

The primary benefits of balloon catheter dilatation are that it acts as a nasolacrimal duct dilator without requiring a follow-up treatment, and it takes less time than silicone intubation.

The primary drawback, meanwhile, is the expensive treatment-related disposable balloon catheter.

• Surgery

Through a surgical technique called dacryocystorhinostomy (DCR), the obstructed tear duct is bypassed and a new pathway for tears to exit the eye is created.

It is seldom done on children and is usually done on adults who have not responded to previous therapies. 

 Types of DCR(Dacryocystorhinostomy)

• External DCR:

A little incision is made on the side of the nose by the surgeon during this treatment, and it is stitched up. The lacrimal sac and nose are then connected by the surgeon making a little cut in the bone underneath. Sometimes, to aid in maintaining the new tear duct's opening, a little tube is left in situ.

• Endoscopic DCR:

In this minimally invasive procedure, the surgeon inserts tiny instruments and a camera through the opening of the nose. This method causes less pain and does not leave scars.

The surgeon will place a tube inside the new opening while it heals, which is usually removed after three or four months.DCR usually relieves the tear duct blockage and its symptoms, but possible side effects include infection, scars from external surgery, stuffy nose, bruises, and nosebleeds

Diagnosis

We may do some tests to determine whether you have a blocked tear duct, such as:

• Tear drainage test:

This measures the rate at which your tears are dripping out. Each eye is given one drop of a unique dye; if, after five minutes, the majority of the dye is still on the surface of your eye, you may have a blocked tear duct.

• Irrigation and probing:

To check how well your tear drainage system is draining, We may pump a saline solution through it. As an alternative, you can check for obstructions by inserting a thin device into the puncta, which are tiny drainage pores at the corner of your lid. Sometimes, the problem might even be solved by this probing.

• Eye imaging tests:

During these operations, your tear drainage system is used to channel a contrast dye from the puncta in the corner of your lid. Subsequently, an X-ray, CT scan, or MRI is utilized to determine the blockage's position and origin.

• Dacryocystography: 

A specialized radiography test is used to determine whether the tear ducts are blocked. To find out if the tear duct is obstructed or whether tears are freely flowing from the eye into the nose, radiographic dye is injected into the tear canal, and radiographic images are obtained.

• Dacryoscintigraphy:

This examination entails putting a contrast dye into the tear drainage system and monitoring the dye's movement with a specialized camera. 
 

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