Dacryostenosis (nasolacrimal duct obstruction) is narrowing of the nasolacrimal duct, which drains tears away from the eye.

Dacryostenosis can be present from birth (congenital) or develop after birth (acquired). Either type can lead to tearing or an infection of the lacrimal sac (dacryocystitis).

Congenital Dacryostenosis: Congenital dacryostenosis (congenital nasolacrimal duct obstruction) can result from inadequate development of any part of the nasolacrimal ducts. The result is an overflow of tears that run down the cheek (epiphora) or persistent crusting. One or both eyes can be affected. The problem is usually first noticed in 3- to 12-week-old infants. This type of blockage usually disappears without treatment by the age of 6 to 9 months, as the nasolacrimal system develops. Sometimes the blockage resolves faster when parents gently massage the area above the duct with a fingertip.

If the blockage does not clear up, an ear, nose, and throat specialist (otorhinolaryngologist) or an eye specialist (ophthalmologist) may have to open the nasolacrimal duct with a small probe, which is usually inserted through the duct opening (lacrimal punctum) at the corner of the eyelid.

Acquired Dacryostenosis: Acquired dacryostenosis is often a result of age-related narrowing of the duct but can also occur from scarring after an injury or surgery. Simply inserting a probe as is done with congenital dacryostenosis is generally not effective. If dacryostenosis causes persistent, bothersome tearing or repeated episodes of infection, surgery may be needed.

Last full review/revision November 2007 by James Garrity, MD