Tear Duct Surgery

Surgery should be performed by a pediatric ophthalmologist who is familiar with the procedure - your child's doctor should be able to refer you to such a specialist. These surgical procedures are done on an outpatient basis (unless your child is suffering from a severe infection and has already been admitted to the hospital) under general anesthesia.

When a child is referred for a blocked tear duct because of an infection or excessive tearing, a pediatric ophthalmologist will do a complete eye exam to rule out any other eye problems or types of inflammation that might be causing similar symptoms.

A dye disappearance test also may help determine the cause of the problem. This involves placing fluorescein dye in the eye and then examining the tear film (the amount of tear in the eye) to see if it's greater than it should be. Or the doctor will wait to see if dye has drained properly by having the child blow his nose and then checking to see if any of the dye exited through the nose.

A surgical probe takes about 10 minutes. A thin, blunt metal wire is gently passed through the tear duct to open any obstruction. Sterile saline is then irrigated through the duct into the nose to make sure that there is now an open path. Infants experience no pain after the probing.

If surgical probing is unsuccessful, your child's doctor may recommend further surgical treatment. The more traditional form of treatment is called silicone tube intubation. In this procedure, silicone tubes are placed in your child's tear ducts to stretch them. The tubes are left in place for 6 months and then removed in another short surgical procedure. A newer form of treatment is balloon catheter dilation (DCP) or LacriCATH. In this procedure, a balloon is inserted through an opening in the corner of the eye and into the tear duct. The balloon is inflated with a sterile solution to expand the tear duct for 90 seconds. It is then deflated and reinflated for 60 seconds before being repositioned slightly higher in the duct and inflated twice again. It's then deflated and removed.

Both of these procedures require that your child be put under anesthesia and are fairly short - your child will be in surgery for less than an hour. Also, both procedures are considered to be generally successful. There is an approximate 80% to 90% success rate in younger children, with the chance of success decreasing if the procedure is done at older ages.

It may take up to a week after surgery before your child's symptoms improve. Your child's doctor will give you antibiotic ointment or drops along with specific instructions on how to care for your child.