The tear system in our eyes is like a shower system. We have a tear gland that is always making tears, even when we are not crying, and we have a drain pipe (or tear duct) that drains the tears directly out of our eyes into our nose, which is why when we cry we get a runny nose. Some little children are born with a blockage in the bottom of the tear duct, and what we see then is similar to what happens when a shower drain is blocked up.
The first thing you would see is a bunch of water in the bottom of the shower, and when you look at these children, we see a thin rim of water in the eye. The next thing that would happen with a blocked up shower drain is that it would overflow onto the floor. In these children, what you will see are tears running down their cheek even when they are not crying. The third thing that happens, because the tears do not flush properly, is the children get recurrent infections, and you will see yellow or green discharge in the corner of the eye.
This is very common and frequently clears by the time the children get to be five or six months of age. If the children do not clear by one year of age we usually like to unplug the system. If the children are 7 ½ months old, and have not cleared, we recommend that they have a relatively simple operation called a probing and irrigation of the tear duct system. What we do is take a very fine probe, pass it down through the system and break through the obstruction. Then we irrigate through the system and flush out any pus or discharge. This is done in the hospital, as an outpatient, under what we call light general anesthesia.
The success rate of a tear duct probe is over 90 percent, but is not 100%. Occasionally, children will require a second tear duct procedure.
Our usual routine is to speak to our surgery coordinator to schedule your child’s surgery date. she will review your child’s pre-operative instructions with you and give you written instructions. The morning of surgery you will go to the hospital to have the tear duct probing. Your child will be ready to go home within several hours after the probe. There are no bandages and there is no pain. The children do great.
There are eye drops that we may use for three days before the tear duct probing. After the procedure, the eye drops will be used for 7 days.