Tear duct surgeries in children

The tear ducts contain delicate tubes in the upper and lower eyelids that connect to the nasolacrimal sac located on the lateral wall of the nose. The tears empty into the nasal cavity through the nasolacrimal duct.

Anatomy of the tear ducts

Lacrimal duct cannulation, irrigation, and insertion of a silicone tube

Many babies are born with a partial blockage of the tear duct, and present with recurrent eye infections, swelling, and redness in the lacrimal sac area (between the eye and nose).
In most cases (95%) congenital obstruction resolves spontaneously without surgical treatment.
However, in cases of congenital obstruction, it is recommended to massage the lacrimal sac in order to empty the sac of tears and pus. When massage does not help, the lacrimal ducts can be flushed and a fine metal tube can be passed through the drainage system to open the obstruction. In some cases, a silicone tube can be left in the system to prevent recurrence of the obstruction. Today, there is a method for expanding the lacrimal duct using a balloon (Dacryoplasty). A silicone tube is also inserted into the lacrimal drainage system in cases of injury to the eyelids with a tear in the lacrimal duct. Lacrimal duct bypass surgery (see below) is not common at a young age, and is only performed when other treatments do not help and the child suffers from persistent tearing with or without recurrent infections (in the lacrimal sac or in the eyes).

Eye infections due to blocked tear drainage