Lacrymal duct Lacrymal duct

Pathologies of the tear ducts


The lacrimal ducts allow the drainage of tears secreted by the eye towards the nose. Obstruction of the lacrimal passages causes tearing.

Dr. Bela takes care of all pathologies of the lacrimal ducts.

Tearing is due to two causes.

Either it is a hypersecretion of tears by the lacrimal gland in response to local irritation (blepharitis, trichiasic eyelash, foreign body, malposition of the eyelids).
Either it is an obstruction in the evacuation path of the lacrimal passages (partial or complete obstruction; congenital or acquired).


    In children tearing is most often due to a congenital malformation of the lacrimal ducts. This is more common in premature babies.

    Obstruction of the lacrimal ducts results in chronic and permanent lacrimation, from birth.

    It is unilateral or bilateral.

    The tears are clear but episodes of infectious conjunctivitis can complicate this picture and cause purulent secretions.

    Additional tests
    In the office, a slit lamp examination is carried out to look for the causes of tearing.

    No x-rays or CT scans are performed on children.

    From birth to the fourth month 98% of children heal spontaneously or with daily massage of the lacrimal sac without treatment.

    Between the fourth and the twelfth month, a simple catheterization can be proposed in the event of frequent superinfections.

    From the age of 1 year a sounding associated with intubation with a silicone probe is indicated. There is no incision, everything is done by natural means. The procedure is performed on an outpatient basis under general anesthesia. The probe is left in place for 6 to 8 weeks and then removed in the office without anesthesia and without pain.

    From the age of 6, in the event of failure of previous treatments, surgery to bypass the lacrimal ducts is proposed, in the operating room under general anesthesia. A probe is then put in place for 3 months and removed in the office without anesthesia and without pain.

    In adults


      In adults tearing is most often due to blepharitis. The tearing is then bilateral and fluctuating: it predominates in the wind and in the cold.

      When the lacrimation is related to an obstruction of the tear ducts, the lacrimation is unilateral or bilateral. The eyes are constantly running. The tears are clear or purulent depending on the location of the obstruction.

      Additional tests
      A complete ophthalmological examination is carried out in order to eliminate an irritant cause: blepharitis, malposition of the eyelids, trichiasic eyelash or foreign body.
      Dr. Bela will probe and flush the lacrimal ducts with saline to determine the degree of stenosis. This is done in the office, without anesthesia and without pain
      A CT scan will be ordered to identify the location and degree of obstruction.

      Treatment varies depending on the degree of obstruction:

      partial stenosis: intubation of the lacrimal passages by a silicone probe under general anesthesia, on an outpatient basis.

      complete stenosis: tear duct diversion surgery: DCR or Dacryocystorhinostomy
      This is a surgical procedure that creates a new flow path for the tear ducts. The flow will still be in the nose but by another route. A probe is placed at the end of the intervention in this new path. Here is some information about this surgery:

      Duration: 1h with one night of hospitalization

      General anaesthesia


      Anesthesia consultation before surgery
      Fasting on the day of the operation
      Exit the next day without dressing
      Postoperative follow-up:

      A probe is placed, visible in the inner corner of the eye but without pain
      Do not blow your nose, do not rub your eye and do not pull on the probe
      Lacrimation persists until the catheter is removed
      Frequency of appointments:

      D1: Appointment with Dr. Bela to remove the bandage
      D7: removal of sutures
      M3: removal of the probe in consultation and without pain