Should my baby have a probing procedure to open a blocked tear duct?
Introduction
This information will help you understand your choices, whether you share in the decision-making process or rely on your doctor's recommendation.
Key points in making your decision
Although there are surgical options for opening a blocked tear duct, this information deals only with the probing procedure. The probing procedure is commonly used to open a blocked tear duct in a baby 6 to 12 months old. Consider the following when making your decision:
- Most blocked tear ducts open on their own by the time a baby is 1 year old. If your baby is almost 12 months old and the tear duct remains blocked, probing may be recommended. It may also be advised if your baby has developed a bluish, bulging area along the side of the nose (dacryocystocele) or is becoming increasingly irritable because of the blockage.
- If your baby is 6 to 12 months old and has had repeated eye infections, scarring may have occurred that makes the opening unlikely to occur naturally.
- Any medical procedure carries some risks. A rare but major risk of probing is that it may cause scarring of the eye's drainage system, which may lead to further blockage and increase the difficulty of opening the tear duct during a repeat procedure.
- A blocked tear duct does not damage vision. Delaying or not having the procedure will not affect your child's ability to see.
- When or whether to have probing is in part a personal decision. If you are uncomfortable with your baby's appearance or find it difficult to keep his or her eye clean, you may want to consider this procedure.
Medical Information
What should I know about the probing procedure for opening a blocked tear duct?
The probing procedure to open a blocked tear duct is usually not done in a baby younger than 6 months of age.
This procedure can be done in a doctor's office using local anesthesia. However, it is usually done in a surgical centre or hospital using general anesthesia. A doctor may use his or her judgment about the need for anesthesia based on the child's age, weight, and temperament.
Sometimes a probing procedure has to be repeated. Three weeks after surgery, in the doctor's office, the child's tear duct is checked with a dye solution. If the duct is still blocked, massage and antibiotics are used for 4 to 6 more weeks. Then, if excessive tearing continues, the probing procedure is done again.
Symptoms may return for a short time after the probing procedure is done if the child gets an upper respiratory infection, such as a sinus infection or a cold.
How effective is the probing procedure for blocked tear ducts?
More than 90% of blocked tear ducts go away on their own by a baby's first birthday.1 If a child's tear duct has not opened by the time he or she is 12 to 13 months old, the probing procedure for blocked tear ducts is usually done. Probing procedures are successful in more than 90% of cases.1 Therefore, the decision about whether to have a probing procedure for blocked tear ducts in babies younger than 1 year of age is more a matter of personal choice.
When a child is 18 months to 4 years old, the probing procedure opens blocked tear ducts 95% of the time if the blockage is caused by a simple obstruction.2 A simple obstruction usually occurs when a thin tissue covering the opening at the end of the tear duct does not open normally at or near birth. For more complicated types of obstructions in children of this age group, the probing procedure is successful 58% of the time.2
What are the risks of having a probing procedure to open a blocked tear duct?
Every medical procedure has some risks, such as infection and bleeding. These risks are also present with a probing procedure to open blocked tear ducts.
One of the major but rare risks of a probing procedure is scarring of the drainage system between the eye and the nose (lacrimal duct). The scarring cannot be seen on the baby's face. However, scarring may lead to further blockage, increasing the difficulty of opening the tear duct during a repeat probing.
There are also risks associated with anesthesia.
- General anesthesia has greater risks than local anesthesia. Children ages 12 months and older usually need general anesthesia to keep them perfectly still during the procedure. A doctor may prefer general anesthesia for some babies younger than 12 months, depending on their temperament.
- Local anesthesia has few or no risks. Babies 6 to 12 months old may have local anesthesia during the probing procedure. But they will need to be restrained to keep them very still during the procedure.
What are the risks of delaying or not having a probing procedure to open a blocked tear duct?
The risks of delaying or not having a probing procedure to open a blocked tear duct are minimal in babies ages 12 months and younger.
- In very rare cases, a baby may develop serious infections of the areas surrounding the eye, including infection of the lining around the eye (pink eye, or conjunctivitis), the skin around the eye (cellulitis), or the tear duct sac located inside and below the lower lid (dacryocystocele). These infections occur because tears well up behind the blockage and provide a place for bacteria to grow.
- Repeated infections from blocked tear ducts may result in scarring of the tear duct (lacrimal duct). This complication is rare and is usually corrected by probing.
Another risk of delaying probing is that babies ages 12 months and older usually need general anesthesia to ensure that they remain very still during the procedure. However, some babies 8 to 12 months old may also need general anesthesia.
A child's vision is not impaired by a blocked tear duct; therefore, delaying or not having the procedure to open a blocked tear duct will not damage your child's ability to see.
If you need more information, see the topic Blocked Tear Ducts.
Your Information
Your choices are:
- Have a probing procedure to open your baby's blocked tear duct if your baby is 6 months to 1 year old.
- Wait until your baby is 1 year old and then reconsider whether this procedure is needed.
The decision about whether to have a probing procedure to open your baby's blocked tear duct takes into account your personal feelings and the medical facts.
Probing procedure to open a blocked tear duct Reasons to have a probing procedure to open your baby's blocked tear duct Reasons not to have a probing procedure to open your baby's blocked tear duct
- Your child has turned 1 year old and still has a blocked tear duct.
- Your child has had repeated eye infections, and scarring has made the opening of the duct unlikely.
- Your child has developed a bluish, bulging area alongside the nose (dacryocystocele).
- Your baby has become increasingly irritable because of the blockage.
Are there other reasons you might want to have a probing procedure to open your baby's blocked tear duct?
- Most blocked tear ducts open without probing by the child's first birthday.
- You decide to wait until your baby is 1 year old and then re-evaluate the need for the probing procedure.
- Any procedure involving anesthesia carries some risk.
- Although rare, there is a risk of scarring of the drainage system between the eye and nose, which can lead to further blockage.
Are there other reasons you might not want to have a probing procedure to open your baby's blocked tear duct?
These personal stories may help you make your decision.
Wise Health Decision
Use this worksheet to help you make your decision. After completing the worksheet, you should have a better idea of how you feel about having a probing procedure to open your baby's blocked tear duct. Discuss the worksheet with your doctor.
Circle the answer that best applies to you.
It bothers me to see tears flowing from my baby's eye even when he or she is not crying. Yes No NA* I'm uncomfortable when people see tears flowing down my baby's face or dried drainage in his or her eyes. It keeps me from taking my baby out. Yes No NA I have a special event coming up in which my baby's appearance is important to me. Yes No Unsure It's hard for me to see drainage in my baby's eyes, and sometimes his or her eyes stick together. It's difficult to keep his or her eyes clean. Yes No NA My baby has had serious or frequent infections of the eyelids, tear ducts, or skin around the eyes due to the blockage. Yes No Unsure It's difficult for me to apply antibiotic drops or ointment to my baby's eyes. Yes No Unsure I am concerned about my child being given general anesthesia to have the probing procedure. Yes No Unsure I am concerned about my child undergoing the probing procedure while he or she is awake. Yes No Unsure My provincial health plan will pay for the probing procedure. Yes No Unsure *NA = Not applicable
Use the following space to list any other important concerns you have about this decision.
What is your overall impression?
Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to have or not have a probing procedure to open your baby's blocked tear duct.
Check the box below that represents your overall impression about your decision.
Leaning toward having the probing procedure
Leaning toward NOT having the probing procedure
Return to the topic Blocked Tear Ducts.
| Author: | Amy Fackler, MA Carrie Henley | Last Updated: June 12, 2006 |
| Medical Review: | Adam Husney, MD - Family Medicine Michael J. Sexton, MD - Pediatrics Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics | |
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