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A swollen tear duct usually means that there is a blockage that prevents tears from draining normally. It is common in infants when tear ducts did not open properly before birth and in cases of an eye or sinus infection that blocks the normal flow of tears. In adults, a swollen tear duct can result from a thickening of the duct canal, a tumor, sinus problems or an injury.
Babies are sometimes born with poorly developed tear ducts, especially if they are premature at birth. Another birth defect that causes a swollen tear duct involves improper bone growth in the nasal canal that impedes tears from draining. Children born with these conditions tend to have more frequent eye or sinus infections that may be uncomfortable, but usually do not affect vision.
A tiny gland above each eye produces tears that keep the eyeballs moist. The tears lubricate the eye before traveling into minute holes in the upper and lower eyelids. From there, the tears go into a small sac near the nose where they either are reabsorbed by the body or they evaporate. A blockage that causes a red, swollen tear duct can occur anywhere along the canal that carries tears.
Symptoms of a swollen tear duct commonly include redness and inflammation. Such symptoms typically show up in babies within days or weeks after birth, and might include a yellow discharge if infection is present. The eyelids might become crusty and stick together when the discharge dries on the lids. In some infants, the condition is aggravated by the sun, wind or cold weather.
There is no way to prevent a swollen tear duct caused by a birth defect. Parents are usually advised to keep the area clean by swabbing the eyes with cotton balls soaked in warm water until the ducts open on their own. Keeping the baby inside on cold or windy days can help prevent tearing and infection from developing, along with providing a hat and eye protection from the sun.
Treatment for swollen tear ducts usually involves antibiotics to clear up an infection that clogs the ducts. If the condition is congenital, it commonly goes away by the child’s first birthday. If it is still present, the swollen tear ducts can be manually opened with a small, wire probe under general or local anesthetic. Water containing a dye is typically flushed into the tear duct along with the probe to allow the doctor to see if the blockage is cleared.
In some cases, adults with swollen tear ducts may require surgery if a tumor or other obstruction is pressing on the sinuses. This is also a common treatment if a facial injury prevents the normal flow of tears. When a sinus infection or upper respiratory infection contributes to swollen tear ducts, antibiotics can often correct the condition.