Lacrimal duct probe

Cause

Being born with an underdeveloped tear-duct system can lead to tear-duct blockage, excess tearing, and infection. In infants, it usually resolves by age one. Eyelids move tears across the eyes. Tears keep the eyes lubricated and clean and contain antibodies that protect the eyes from infection.

Excessive tears move down the lacrimal sac to the nasolacrimal duct and drain into the back of the nose.

It's the nasolacrimal duct that's involved in tear-duct blockage.

Causes of blocked tear ducts

Congenital nasolacrimal duct obstruction or dacryostenosis

Most commonly, an infant is born with a duct that is too narrow or has a web of tissue blocking the duct and, therefore, doesn't drain properly or become blocked easily

Other causes could be cysts, nasal growth, or trauma

Symptoms

Excessive tearing and pus in the corner of the eyes

Surgical Treatments

Placement of probe under general anesthesia

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 ensure an open path. There's minimal discomfort after the probing, which takes about 10 minutes

Another option is silicone tube placement, which involves stretching the tear ducts

• The tubes are usually left in place for 6 months

A newer form of treatment is balloon catheter dilation, in which a balloon is inserted through an opening in the corner of the eye and into the tear duct

Both procedures are relatively short but require that a child be put under anesthesia. They are generally successful, with an approximate 80% to 90% success rate in younger kids.

Anesthetic considerations

Immobile patient

Use of LMA

Monitor for oculocardiac reflex