Tear Duct Probing and Irrigation

Tear duct probing and irrigation is a procedure used in the treatment of nasolacrimal duct obstruction.

Tears drain from the eyes through the upper and lower punctum, or small openings in the eyelids that are located in the corner of the eye near the nose. The tears then flow into the lacrimal sac and then through the tear duct which empties into the nose.

A blocked tear duct occurs when a thin membrane covers the end of the tear duct or when a blockage occurs in the tear duct. Nasolacrimal duct obstruction occurs frequently. About a quarter of all infants are born with this condition.

Many times, the blockage will open spontaneously as the infant grows. However, sometimes the blockage does not resolve itself. If it has not resolved by 12 months of age, it is unlikely that it will resolve itself.

Blocked tear ducts can cause recurrent eye infections as well as excessive tearing. After a complete eye exam, a pediatric ophthalmologist will determine if a child needs a tear duct probing and irrigation. A tear duct probing and irrigation is done in the operating room under general anesthesia.

A few days before the surgery, a nurse from the same day surgery department will contact the parents of the child. He or she will confirm the scheduled surgery time and determine what time the child should arrive at the hospital on the day of surgery.

The parents are also asked to bring a list of all medicines the child is on as well as a physical exam form completed by the pediatrician. If a child takes medicines routinely, he or she can usually take the morning dose with a sip of water. Notify the doctor of any morning medications prior to surgery.

On the day of the procedure, the patient should dress in comfortable clothing. Jewelry and fingernail polish should not be worn. Eating and drinking instructions are age-specific. This information will be reviewed when the same day surgery nurse calls.

A doctor or nurse practitioner from the anesthesia department will talk to the parents about the anesthesia. They will also answer any questions the family has.

The procedure will take place in the operating room. Children who are over the age of 1 may have one parent come back to the induction room to be with them as they fall asleep. This is dependent on the child's state of health and at the discretion of the anesthesia provider.

The child will be asleep for the entire procedure and will not feel any pain or any other sensations. He or she will be monitored by nurses and doctors throughout the procedure.

The ophthalmologist will carefully pass a tiny, blunt, metal wire into the opening of the lacrimal sac and through the tear duct. Sometimes, sterile salt water is injected through the tear duct to make sure it is open. The procedure takes 10 to 20 minutes per eye.

The ophthalmologist will speak to the parents as soon as he or she has completed the procedure. At this time, the doctor will provide after-surgery instructions including the use of antibiotic drops or ointments.

The child will be taken to the recovery room where a nurse will monitor vital signs and make sure the child is comfortable. After the child wakes up, the nurse will call the parents to come and sit with the child. The child will be offered fluids.

Children should not experience any pain after the procedure. However, they may be tired and infants may be fussy. Tylenol or Motrin can be used for discomfort if necessary. Children may also experience some nausea and vomiting after surgery. Tears and nasal secretions may be tinged with blood.

The patient should start with a clear liquid diet: sugar water, Gatorade, Kool-Aid, Jell-O, apple juice, clear soft drinks or breast milk. He / she may then advance the diet as tolerated.

There are generally no activity restrictions after a tear duct probing. The patient may be tired and unsteady due to the anesthesia, so adult supervision is recommended for a few hours after the procedure.

Contact your child's doctor if excessive bleeding or swelling occurs. You may call the ophthalmology nurses with any questions, 513-636-4751.

Last Updated 04/2015