Overflow Tearing

Definition

Overflow tearing occurs because of a narrowing or blocking of the canaliculus, a part of the nasal lacrimal drainage system. It is a common birth condition found in infants. It occurs when a membrane covering the tear duct inside the nose fails to open at or before birth, thus clogging the nasal lacrimal drainage system. The blocked system can spontaneously open within a few months of birth, or it can be surgically opened. Overflow tearing can also occur when the child's eyelashes stick together after sleep, a situation which can cause one or both eyes to become chronically infected; or when environmental irritants irritate the eye.

Symptoms

• Excessive tearing
  

The symptom described above may not necessarily mean that you have overflow tearing. However, if you experience one or more of these symptoms, contact your eye doctor for a complete exam.

Treatment

Medication

Initially, your doctor may recommend antibiotic eye drops or ointment used once or twice daily, along with pressure (or massage) over the tear sac. To apply this pressure, place a finger under the inner corner of the eye next to the nose, and roll the finger over the bony ridge, pressing down and in. Following this pressure on the tear sac, place an antibiotic in the eye.

Surgery

If the tearing persists, it may be necessary for the ophthalmologist to open the tear ducts by probing and irrigation.

A thin, blunt metal wire is gently passed through the nasal lacrimal drainage system to open any obstruction and fluid is then irrigated through the system. Infants experience no pain after the probing, but some blood-tinged tears or nasal secretion is common. A discharge from the eye may be present for up to a week and antibiotics may be prescribed. Obstruction can reoccur, and if so a repeated probing may be needed. If probings are not successful, plastic or silicone tubes can be placed into the drainage canals. This is a longer procedure than probing and requires a general anesthesia.

As with any surgical procedure, infection or bleeding can occur, or scarring can re-obstruct the opening, and require additional surgery.

Clinic Information

For more information, see the Comprehensive Ophthalmology and Cataract Sugery Clinic and the complete Clinic Services listing of the U-M Kellogg Eye Center.