Kuala lumpur: Obstructed tear ducts, a condition that blocks the eye's natural drainage system, could affect people of all ages, with experts warning that low awareness often delays treatment, causing tears to overflow and, in some cases, leading to infections.
According to BERNAMA News Agency, Sunway Medical Centre Velocity (SMCV) Consultant Ophthalmologist and Oculoplastic Surgeon Dr Nazila Ahmad Azli said the condition occurs when the drainage pathway from the eyelids to the nose becomes blocked. This blockage prevents tears from draining normally and causes them to back up and overflow onto the cheeks, a condition known as epiphora.
Dr Nazila explained that excessive tearing can be caused by either overproduction of tears or a blockage in the tear drainage system. Overproduction may result from irritation, infection, inflammation, allergies, or eye conditions such as facial nerve palsy. A blocked tear drainage system, on the other hand, leads to tears overflowing, and patients may also experience sticky discharge. If untreated, the blockage may lead to infection.
Although there are no official national statistics in Malaysia, global data suggests that between 20 and 30 people per 100,000 population are affected by this condition, Dr Nazila noted. The condition typically affects children and adults; in children, it is usually congenital and can affect infants up to three years of age, while in adults, it is usually acquired later in life. Adult cases can appear as early as age 20, but are more commonly seen between ages 40 and 70, with women being more susceptible than men.
Dr Nazila explained that women generally have narrower tear drainage systems, and menopausal hormonal changes, combined with a higher prevalence of dry eyes, may increase the risk of obstruction. To diagnose obstructed tear ducts, an Oculoplastic Surgeon typically begins with a detailed medical history and a physical examination, assessing the pattern of tearing and examining the tear sac area at the inner corner of the eye. Additional tests, such as the dye disappearance test, may be conducted to observe how efficiently a coloured dye drains into the tear duct.
According to Dr Nazila, lacrimal irrigation or syringing may also be performed to determine the location and severity of the blockage. In more complex cases, imaging tests such as dacryocystography or a CT scan may be used. Treatment depends on the severity of the condition and the patient's age. Non-surgical approaches such as gentle massage of the tear sac are usually recommended for infants or mild cases. For persistent blockage in adults, dacryocystorhinostomy (DCR), a surgical procedure to create a new drainage channel, is the definitive treatment.
Dr Nazila stressed the importance of early diagnosis and proper treatment to prevent complications such as recurrent infections or inflammation around the eye. Symptoms such as pain, swelling, redness, or blurred vision require prompt treatment to prevent complications like orbital cellulitis. She advised the public to maintain good eyelid hygiene, including regular warm compresses and using eyelid wipes, to reduce the risk of inflammation.
"If you develop symptoms that are unusual for you, seek help promptly. If left untreated, a blocked tear duct can lead to infection and more sinister complications," she added.