Blocked tear duct and osteopathy

Does your baby have a runny eye all the time? A little crust in the corner of the eye? It is possible that your baby has a blocked tear duct... Explanations in this article : 

The lacrimal duct, also known as the lacrimal or lacrimonasal duct, is the small tube that drains tears from the eye into the nasal cavity. It extends from the lacrimal sac in the inner corner of the eye to the nasal cavity, and is 15 mm long and 3 mm in diameter.

When this duct is blocked, either partially or completely, tears can no longer flow normally. As a result, they stagnate on the surface of the eye, causing constant tearing, sometimes accompanied by repeated infections or redness.

This dysfunction can affect both infants (where it is generally benign and transient) and adults, in whom it can progressively take hold and require specialized treatment.

Sometimes, one or two ducts may be blocked or misplaced in a toddler. This can happen at birth or after a few weeks.

• Persistent tearing Even without crying, the baby's eye always seems wet. Tears spill over and run down the cheek, often continuously or recurrently.
   
• Regular "sticky" eyes: In the morning, or after naps, the eyelids may be partially or totally glued shut by secretions. These discharges are often mucoid or purulent (yellow/greenish).
   

• Accumulation of crusts in the inner corner of the eye: A small crust or sticky deposit forms regularly in the inner canthus (corner of the eye near the nose), even after cleansing.

• Frequent infections (conjunctivitis): Blockage of the canal promotes tear stagnation, which can lead to recurrent, often unilateral, bacterial conjunctivitis.

• Only one eye affected (often): The obstruction is usually unilateral (only one eye affected), but it can also affect both eyes.

• Otherwise normal eye : The eye remains white (with no marked redness or swelling of the conjunctiva), helping to differentiate simple obstruction from isolated conjunctivitis. In the case of secondary infection, however, the eye may turn red.

Tear sac massages (Crigler technique)

Massage is often the first-line treatment, especially before 6 months.

• Frequency: 2 to 4 times a day.

• Technology:

  • Wash your hands thoroughly.

  • Place your index finger at the inner corner of the eye (near the root of the nose).

  • Apply light pressure and massage towards the nose, making a small downward movement (as if "emptying" the lacrimal sac).

  • This gesture can help to mechanically unclog the canal and promote its opening.

It's normal for fluid (clear or yellow) to come out of the eye during massage: this is a sign that secretions are being mobilized.

Regular eye cleaning

• Use a sterile compress soaked in saline solution to gently clean secretions.

• Clean from the outside to the inside of the eye, one clean compress per eye each time.

• Avoid non-sterile wipes or cotton.

Monitoring for signs of infection

• In the event of severe redness, swelling, fever or eyelid edema, seek prompt medical attention.

• Secondary bacterial conjunctivitis may require treatment with prescribed antibiotic eye drops.

Patience: obstruction is often transient

• In 90% of cases, the canal opens spontaneously before the age of 6 to 12 months.

• Regular medical check-ups are generally all that's needed, without any invasive procedures.

Specialist consultation if persistent

• If obstruction persists beyond 9-12 months, or in the case of repeated infections, a pediatric ophthalmologist may consider :

  • An in-office lacrimal lavage.

  • Tear duct probing under light anesthesia.

If manual treatment fails, an operation is possible, but generally not before the child is 12 months old, as the canal is likely to unblock on its own or with manual treatment.

The procedure is performed under local or general anesthesia, depending on the condition, using a small probe. The procedure is performed by an ophthalmologist and lasts only a few minutes. This small operation is very impressive for the parents but not very painful for the child.

The role of the osteopath, in the case of an obstructed tear duct, is to restore the mechanics of the cranium and the face. To do this, thanks to very gentle and non-painful specific techniques, he will work on the bones of the skull and especially the face (nose and orbit) and treat all the tensions likely to close the tear ducts. 

The osteopath will treat the child in its entirety, that is to say from head to toe in order to rebalance the body as much as possible to allow it to function optimally.

Your practitioner will also give you tips on how to remove the blockage of the tear duct and how to massage the corner of the eye.

However, osteopathy has its limits! If the canal is completely obstructed because of a membrane, osteopathy will not have any effect on this and it will be necessary to consider an intervention.

Marie Messager
Osteopath specialized in pediatrics
In Versailles
78000 - Yvelines