The nasolacrimal duct is a tiny tube that carries tears from the eye into the nose. The duct starts at small openings on the eyelid edges called puncta. The puncta connect to short channels called canaliculi. The canaliculi join a small tear reservoir called the lacrimal sac. The sac narrows into the nasolacrimal duct, which opens inside the nose. When this passage is open, tears drain quietly without you noticing. When any part of this passage gets blocked or too narrow, tears cannot flow out properly. Tears then pool on the eye surface and spill over the eyelid. This is called nasolacrimal duct obstruction. In very simple terms, the tear drain is clogged.
Nasolacrimal duct obstruction (NLDO) means the tiny drainage pipe that carries your tears from the inner corner of your eyelids into your nose is partly blocked or fully blocked. Tears are made on the eye surface, then they normally flow through small openings called puncta (one on the top lid and one on the bottom lid), into small channels (canaliculi), into the lacrimal sac, and then down the nasolacrimal duct into the nose.
If any part of that system is narrow, kinked, inflamed, scarred, pressed on by a lump, or sealed by a thin membrane, tears cannot drain well. The tears then overflow onto the cheek (called epiphora). Because tears and mucus sit in a warm pocket, germs can grow there, causing recurrent sticky discharge or lacrimal sac infections (dacryocystitis). NLDO can be present at birth (congenital) or can start later in life (acquired).
Tears are not only for crying. Tears wash the eye, feed the surface cells, and carry away dust and germs. When tears cannot leave the eye, the tear lake stays too full. Germs can grow in the trapped fluid. The skin under the eye may get sore. The inner corner of the eye may swell. Repeated infections can happen. In babies the blockage is often due to a thin membrane that did not open at birth. In adults the blockage is usually due to swelling, scarring, or age-related narrowing of the drain.
Types of nasolacrimal duct obstruction
By age of onset
Congenital NLDO: The blockage is present at birth. It often comes from a thin membrane at the outlet of the duct in the nose (near the “valve of Hasner”). Many babies outgrow it in the first months as the membrane opens.
Acquired NLDO: The blockage develops later in life. It may come from inflammation, infection, injury, surgery, or age-related changes.
By cause in acquired cases
Primary acquired NLDO (PANDO): The duct narrows by itself over time, often in midlife or older adults, commonly in women. Low-grade inflammation and age-related tissue changes play a role.
Secondary acquired lacrimal drainage obstruction (SALDO): A known outside cause blocks the passage. The cause can be infection, inflammation, trauma, tumor, drug effect, radiation, or surgery.
By location of the blockage
Punctal obstruction: The tiny eyelid opening is closed or too tight.
Canalicular obstruction: The short channels inside the eyelid are blocked.
Common canaliculus obstruction: The joining segment before the sac is blocked.
Lacrimal sac obstruction: The reservoir area is diseased or filled.
Nasolacrimal duct obstruction: The long tube from the sac to the nose is blocked.
By pattern of blockage
Anatomical (structural) obstruction: Tissue or scar physically closes the path.
Functional obstruction: The path is open, but the tear pump does not work well (for example, from weak blinking or eyelid malposition). Tears still do not drain normally.
By degree and timing
Partial vs. complete: Partial means tears pass slowly; complete means no passage.
Intermittent vs. constant: Symptoms may come and go or stay all the time.
Acute vs. chronic: Acute means sudden and short; chronic means long-lasting.
With infection vs. without infection: Infection of the sac is called dacryocystitis.
By side
Unilateral: One eye is affected.
Bilateral: Both eyes are affected.
Causes
Membrane at birth (valve of Hasner not open)
In many newborns a thin membrane at the nose end of the duct does not open right away. Tears cannot exit and pool in the eye.Narrow or missing puncta at birth
The eyelid opening may be very small or absent. Tears cannot enter the drain.Canalicular malformation in babies
The short tear channels may be under-developed and too narrow for flow.Chronic nasal allergy (rhinitis)
Swollen nasal lining can squeeze the duct where it opens into the nose.Chronic sinusitis
Long-standing sinus infection or swelling can narrow the duct area.Primary age-related narrowing (PANDO)
With age the duct lining may thicken and scar. The passage closes slowly.Nasal septum deviation or turbinate enlargement
Crooked septum or big nasal turbinates can press on the duct outlet.Facial or nasal trauma
Nose or midface fractures can kink or scar the duct and the sac.Naso-orbito-ethmoid fracture
A crush injury in this region can distort the lacrimal sac and channels.Nasal or sinus surgery scarring
After procedures like septoplasty or sinus surgery, scar tissue may close the duct opening.Radiation therapy to the face
Radiation can cause long-term scarring of the duct lining.Drug-induced canalicular scarring
Certain chemotherapy agents (for example docetaxel) and some older antiviral eye drops can scar the canaliculi and narrow them.Chronic eyelid margin disease (blepharitis)
Inflammation at the lid margin can cause punctal narrowing and poor tear entry.Eyelid malposition (ectropion or laxity)
The puncta do not touch the tear lake, so tears cannot enter the drain.Facial nerve palsy
Weak blinking reduces the tear pump action, so tears stagnate.Dacryocystitis (infection of the sac)
Infection causes swelling and pus that can block the path and then scar it.Granulomatosis with polyangiitis (GPA)
This immune disease can scar the nose and the duct and cause obstruction.Sarcoidosis
Granulomas can form in the duct or sac and narrow the passage.Tuberculosis or other chronic infections
These infections can cause persistent inflammation and scarring of the sac or duct.Tumors in the sac or nose
Benign growths (like papillomas) or cancers (like squamous cell carcinoma) can fill or press on the tear path.
Symptoms
Watery eye (epiphora)
Tears collect on the lower lid and often spill down the cheek.Tears worse in wind or cold
More tearing happens outdoors or in cold air because evaporation and reflex tearing increase.Sticky mucus on the lashes
The tears mix with mucus and dry on the lashes, especially after sleep.Yellow or green discharge
Pus can appear if germs grow in the trapped tears.Crusting in the morning
Lashes can stick together after sleep due to dried discharge.Red inner corner of the eye
The tissue near the tear duct looks red from constant wetness and irritation.Swelling near the nose side of the lower lid
The lacrimal sac can swell like a soft lump, especially in infection.Pain or tenderness over the sac
It hurts when you press the inner corner if the sac is inflamed.Backflow when pressed
Mucus or pus may come out of the puncta when you press on the sac.Blurred vision that comes and goes
A heavy tear film can blur sight until you blink or wipe it away.Irritation or gritty feeling
Stagnant tears do not clean the surface well, so the eye feels sandy.Repeated “pink eye” episodes
Conjunctivitis keeps coming back because the tear pool grows germs.Skin soreness below the eye
Constant wetness can make the skin red and sore.Bad smell from discharge
Long-standing infection can produce a foul odor.Fever or feeling unwell in acute infection
Severe dacryocystitis can cause fever and general illness.
Diagnostic tests
The goal of testing is to confirm that the drain is blocked, to find where it is blocked, to learn why it is blocked, and to rule out other causes of tearing such as dry eye, eyelid problems, or eye surface disease.
Physical exam
External eyelid and punctal inspection
The clinician looks closely at the eyelids, lid position, and the tiny puncta. They check if the puncta are open and facing the tear lake. They look for redness, crusts, skin irritation, and signs of eyelid laxity or malposition. This simple look can already suggest where the problem lies.Palpation of the lacrimal sac with ROPLAS
The clinician gently presses over the lacrimal sac (inner corner by the nose). If mucus or pus bubbles back through the puncta, it suggests a full sac and a downstream blockage. If nothing refluxes and there is pain, it can still mean a tight obstruction or an acute infection.Slit-lamp biomicroscopy of the tear film and puncta
A microscope with a bright light is used to examine the cornea, the tear meniscus height, the meibomian glands, and the puncta openings. A high tear meniscus suggests poor drainage. The exam also checks for eye surface disease that can mimic tearing.
Manual tests
Fluorescein dye disappearance test (FDDT)
A safe orange dye is placed in the tear film. After 5 minutes, the clinician checks how much dye remains. If much dye is still present, drainage is likely slow or blocked.Jones dye test I (primary)
Dye is placed in the eye. A small cotton swab is placed in the nose near the duct opening. If dye reaches the nose within a set time, the passage is likely open. If not, there may be a blockage or a weak tear pump.Jones dye test II (secondary)
If Jones I is negative, the clinician irrigates saline through the punctum while checking the nose swab. If dye appears now, the issue may be weak pumping rather than a true blockage. If it still does not appear, a physical blockage is more likely.Lacrimal irrigation (syringing) with saline
A tiny blunt cannula is placed at the punctum. Sterile saline is gently pushed in. If fluid passes into the nose and the person tastes salt, the path is open. If fluid refluxes through the same punctum, an upstream block is likely. If fluid refluxes through the opposite punctum, the blockage is in the common canaliculus or further down.Diagnostic probing of the canaliculi and duct
A thin, smooth probe is advanced through the punctum. The clinician feels where resistance occurs. A “soft stop” suggests mucosal narrowing. A “hard stop” at the lacrimal bone region suggests passage through to the sac. This test maps the blockage site.
Laboratory and pathological tests
Gram stain and culture of discharge
If pus is present, a small sample is taken. The lab identifies the germs and which antibiotics work best. This guides treatment in infected cases.Cytology or histopathology (biopsy) when a mass is suspected
If there is a firm lump, blood-stained discharge, or atypical signs, a small tissue sample from the sac or nearby tissue may be analyzed under a microscope. This tests for benign growths or cancers.Tests for tuberculosis where risk is present (Mantoux or IGRA)
In regions where TB exists or in long-standing unexplained inflammation, a TB test can help identify a treatable infectious cause of the obstruction.Autoimmune and inflammatory markers when indicated
Blood tests such as ANCA (for granulomatosis with polyangiitis) or ACE level (for sarcoidosis) may be ordered if the clinical picture suggests an immune-mediated cause.
Electrodiagnostic tests
These tests are not routine for tear duct disease. They are used only in complex cases where poor blinking or nerve problems are suspected. They help decide if the problem is a functional drainage failure rather than a physical plug.
Blink reflex study (trigeminal–facial pathway)
Small surface electrodes measure how fast and how well the blink reflex fires. If the reflex is weak or delayed, the tear pump may be under-active even if the duct is open.Eyelid electromyography (EMG) for lacrimal pump function
EMG records muscle activity from the orbicularis oculi during blinking. Low activity suggests the pump is not squeezing the sac well. This supports a functional cause of tearing.
Imaging tests
Dacryocystography (DCG)
Contrast dye is gently injected through the punctum, and X-ray images are taken. The pictures show where the passage narrows or stops. It gives a “map” of the blockage.Dacryoscintigraphy (DSG)
A tiny amount of radioactive tracer is placed in the eye as eye drops. A special camera tracks how the tracer moves through the tear path over time. This test is very sensitive to slow flow and can separate pump problems from physical blocks.Computed tomography (CT) of the orbits and sinuses
CT shows the bones, the lacrimal sac area, the duct canal, the nasal septum, and the sinuses. It is helpful after trauma, before surgery, or when bone changes or sinus disease are suspected.Magnetic resonance imaging (MRI) when soft tissue disease is suspected
MRI shows soft tissues well. It helps if a tumor, a mucocele, or deep inflammation is suspected around the sac or the nose.Nasal endoscopy (and, in some centers, dacryoendoscopy)
An ENT surgeon places a thin camera in the nose to look directly at the duct opening and the surrounding mucosa. Dacryoendoscopy uses a micro-camera within the lacrimal passages to see inside the duct. These tools find exact sites of narrowing and guide treatment planning.High-resolution ultrasound of the lacrimal sac (or anterior segment OCT of the tear meniscus)
Ultrasound can show a fluid-filled sac, stones, cysts, or masses. OCT can measure the tear meniscus height non-invasively and support the diagnosis of poor outflow.
Non-pharmacological treatments
These steps are safe first-line or helpful add-ons. They cannot dissolve a hard scar or open a fully blocked duct, but they can reduce symptoms, improve hygiene, and prevent infections while you and your doctor decide next steps.
Crigler lacrimal sac massage (infants)
Purpose: Help open the thin congenital membrane.
How: With clean hands, place a finger just below the inner corner and press firmly downward 5–10 strokes, 4–6 times/day.
Mechanism: Increases pressure in the sac to pop open the membrane at the duct exit.Warm compresses
Purpose: Loosen mucus and improve comfort.
Mechanism: Heat thins secretions so they pass more easily; reduces spasm around the punctum.Lid hygiene
Purpose: Reduce crusting and bacterial load.
Mechanism: Gentle cleaning of lid margins with diluted baby shampoo or commercial lid wipes keeps puncta clear.Hand hygiene & avoid eye rubbing
Purpose: Prevents seeding bacteria into the sac.
Mechanism: Reduces pathogen transfer from fingers to puncta.Humidifier / steam inhalation
Purpose: Soothes nasal mucosa and reduces swelling near the duct outlet.
Mechanism: Moist air decreases mucosal dryness and reflex swelling.Nasal saline irrigation or sprays
Purpose: Clear allergens/mucus from the nose.
Mechanism: Mechanical wash improves the environment where the duct opens.Allergen avoidance
Purpose: Lower nasal and conjunctival inflammation.
Mechanism: Less histamine-driven swelling means a wider duct outlet.Cold compress during allergy flares
Purpose: Quick itch/puffiness relief.
Mechanism: Vasoconstriction reduces edema around the canaliculi.Blink training and screen breaks (20-20-20 rule)
Purpose: Improve the tear pump.
Mechanism: Regular, full blinks move tears into the puncta.Gentle nose-blowing technique
Purpose: Avoid forcing mucus upward into the duct.
Mechanism: Blow with mouth open, one nostril at a time, no straining.Head-of-bed elevation for congestion
Purpose: Reduce nighttime nasal swelling.
Mechanism: Gravity decreases venous pooling in nasal tissue.Cosmetic hygiene
Purpose: Keep puncta clear.
Mechanism: Remove eye makeup fully; replace mascara every 3 months; avoid lining the “waterline.”Contact lens hygiene (if you wear lenses)
Purpose: Lower infection risk.
Mechanism: Proper cleaning schedules and rest days reduce bacterial load.Smoke-free environment
Purpose: Reduce chronic irritation and tearing.
Mechanism: Smoke inflames conjunctiva and nasal mucosa.Protective eyewear in dusty/windy jobs
Purpose: Less debris in tears and puncta.
Mechanism: Physical barrier reduces particulate load.Treat underlying sinus disease with non-drug measures
Purpose: Improve duct outlet health.
Mechanism: Warm showers, saline, and allergy control reduce mucosal swelling.Hydration
Purpose: Keep tears less viscous.
Mechanism: Adequate water supports healthy mucus and tear film.Parent education (infants)
Purpose: Correct massage technique and warning signs.
Mechanism: Consistent home care increases spontaneous resolution.Observation (“watchful waiting”) in many babies
Purpose: Avoid unnecessary procedures.
Mechanism: Most congenital cases open naturally by 6–12 months.Post-procedure care adherence (after probing/intubation/DCR)
Purpose: Prevent re-scarring.
Mechanism: Following cleaning, activity, and follow-up instructions protects the new drainage pathway.
Medication options
Doses are typical adult examples unless noted. Always use the exact plan your own clinician provides, especially for children and pregnancy.
Erythromycin ophthalmic ointment 0.5% (antibiotic)
Use: Infants with sticky discharge or mild conjunctivitis from NLDO.
Dose/Time: A small ribbon in the lower lid 4×/day for 7–10 days.
Mechanism: Blocks bacterial protein synthesis to reduce infection.
Side effects: Mild blur, irritation; allergy is rare.Moxifloxacin 0.5% eye drops (fluoroquinolone antibiotic)
Use: Acute bacterial conjunctivitis or to cover infection risk pre-procedure.
Dose/Time: 1 drop 3×/day for 7 days (regimens vary).
Mechanism: Kills bacteria by blocking DNA enzymes.
Side effects: Stinging; avoid unnecessary use to limit resistance.Amoxicillin-clavulanate (systemic antibiotic)
Use: Acute dacryocystitis (painful, red swelling at inner corner) without abscess.
Dose/Time: Adults 875/125 mg orally every 12 hours for 7–10 days; pediatric dosing is weight-based (doctor calculates).
Mechanism: Broad-spectrum coverage of common skin/nasal bacteria.
Side effects: Stomach upset, diarrhea, rash; rare allergy.Trimethoprim-sulfamethoxazole (TMP-SMX)
Use: Alternative if penicillin allergy or concern for MRSA.
Dose/Time: Adults 1 double-strength tablet every 12 hours for 7–10 days.
Mechanism: Two-step block in bacterial folate pathway.
Side effects: Rash, sun sensitivity; avoid in sulfa allergy and late pregnancy.Doxycycline (tetracycline class)
Use: Canaliculitis, ocular rosacea/blepharitis component in adults.
Dose/Time: 100 mg once or twice daily for 2–4 weeks (per clinician).
Mechanism: Antibacterial and anti-inflammatory effects on meibomian glands.
Side effects: Photosensitivity, stomach upset; avoid in pregnancy and children <8 years.Intranasal corticosteroid (e.g., fluticasone spray)
Use: Allergic rhinitis or chronic sinus swelling narrowing the duct outlet.
Dose/Time: 2 sprays per nostril once daily (adults; pediatric as directed).
Mechanism: Reduces nasal mucosal inflammation and edema.
Side effects: Nose dryness/bleeding; rare irritation.Oral antihistamine (e.g., cetirizine)
Use: Allergy symptoms that worsen tearing.
Dose/Time: Adults 10 mg once daily.
Mechanism: Blocks histamine receptors to reduce itch and swelling.
Side effects: Drowsiness (less with newer agents), dry mouth.Antihistamine/mast-cell stabilizer eye drops (e.g., olopatadine)
Use: Itchy, watery eyes from allergy (not for infants).
Dose/Time: 1 drop twice daily.
Mechanism: Immediate antihistamine + long-term mast-cell stabilization.
Side effects: Mild sting; avoid rubbing.Preservative-free artificial tears (ocular lubricant)
Use: Dilute mucus, protect the surface, improve comfort.
Dose/Time: As needed; frequent users should choose preservative-free vials.
Mechanism: Replaces tear volume and stabilizes tear film.
Side effects: Rare irritation.Acetaminophen or ibuprofen (pain/fever control)
Use: Pain from acute infection or after procedures (if your doctor allows ibuprofen).
Dose/Time: Follow label or clinician instructions; pediatric dosing is by weight.
Mechanism: Central pain/fever relief (acetaminophen); anti-inflammatory (ibuprofen).
Side effects: Liver risk with excess acetaminophen; stomach/bleeding risk with ibuprofen—avoid if your surgeon advises.
Dietary molecular supplements
No supplement can “unblock” a scarred duct. These nutrients may support eye surface, immune balance, or wound healing. Discuss with your clinician, especially if pregnant, on blood thinners, or managing chronic disease.
Omega-3 (EPA/DHA): ~1,000 mg/day EPA+DHA.
Function/Mechanism: Anti-inflammatory; may improve tear film quality.Vitamin A (prefer beta-carotene form): aim for dietary sources; if supplementing, stay within RDA unless supervised.
Mechanism: Supports mucous membranes and goblet cells.Vitamin D3: 800–2,000 IU/day (per blood level and clinician advice).
Mechanism: Immune modulation; may help allergic tendencies.Vitamin C: 500 mg/day.
Mechanism: Collagen support and antioxidant activity.Zinc: 8–11 mg/day (RDA); avoid excessive doses.
Mechanism: Wound healing and immune function.N-acetylcysteine (NAC): 600 mg once or twice daily (if appropriate for you).
Mechanism: Mucolytic; may thin sticky secretions.Lactoferrin: 250 mg/day.
Mechanism: Natural antimicrobial protein; supports tear film in some dry-eye patients.Curcumin (with piperine for absorption): 500–1,000 mg/day.
Mechanism: Anti-inflammatory signaling; caution with anticoagulants.Probiotics (Lactobacillus/Bifidobacterium strains): per label CFU daily.
Mechanism: Gut-immune axis support; may reduce allergy burden.Lutein + Zeaxanthin: 10 mg/2 mg daily.
Mechanism: Antioxidants for general eye health (retina); not specific to NLDO but safe adjuncts.
Regenerative, and stem-cell drugs
There are no proven or approved stem-cell drugs or “immunity-boosters” that reopen a blocked nasolacrimal duct. NLDO is mainly a mechanical problem. Medicines can calm infection and swelling, but a scarred or closed duct usually needs a procedure to restore flow. Below are six biologic or regenerative-style therapies you may hear about in eye care. They are not standard treatments for NLDO; some are used for other eye-surface diseases or as surgical adjuncts under specialist care:
Autologous Serum Eye Drops (ASEDs)
Dose: Often 20% serum, 4–8×/day (regimens vary).
Function/Mechanism: Patient’s own growth factors and vitamins support ocular surface healing.
Note: For severe dry eye/neurotrophic cornea—not for opening tear ducts.Platelet-Rich Plasma (PRP) Eye Drops
Dose: Protocols vary (specialty clinics only).
Mechanism: Platelet growth factors may aid surface repair.
Note: Investigational; not a duct-opening therapy.Amniotic Membrane (biologic graft or contact-lens form)
Use: Heals corneal surface disease.
Mechanism: Anti-inflammatory and pro-healing cytokines.
Note: Surface therapy, not for the tear drainage pathway.Cenegermin (recombinant human nerve growth factor)
Use: Neurotrophic keratitis.
Note: Prescription for a different disease; not for NLDO.Mesenchymal Stem Cell–derived treatments
Status: Experimental in various ocular conditions.
Note: Not approved for NLDO; avoid outside regulated clinical trials.Mitomycin-C (antifibrotic) used during DCR surgery
Dose: Typically 0.2–0.5 mg/mL applied intra-op for 2–5 minutes by the surgeon.
Mechanism: Reduces scar tissue formation at the surgical opening.
Note: A surgeon-applied adjunct, not a take-home medicine.
Surgical options
Probing (with irrigation)
What: A thin probe gently passes through the punctum and canaliculus into the sac and duct to open a membranous block.
Why: First-line in infants that don’t improve with massage by about 6–12 months; also used diagnostically in adults.Balloon dacryoplasty (balloon catheter dilation)
What: A tiny balloon is placed into the duct and inflated for seconds to widen a narrow segment.
Why: For partial obstructions or after probing failure, especially in children and select adults.Silicone intubation (stenting)
What: Soft silicone tubes are threaded through the canaliculi into the nose and left for weeks to months.
Why: Keeps the pathway open while the lining heals to prevent re-scarring; often combined with probing/balloon.Dacryocystorhinostomy (DCR) — external or endoscopic
What: Surgery creates a new, permanent window between the lacrimal sac and the nasal cavity, bypassing the blocked duct. External DCR uses a small skin incision; endoscopic DCR uses a nasal scope (no skin cut).
Why: Gold-standard for adult NLDO and for long-standing or complete blockages. Your surgeon will choose external vs endoscopic based on anatomy, sinus disease, and expertise.CDCR with Jones tube (for canalicular obstruction)
What: If the canaliculi themselves are scarred shut, a small glass or Pyrex tube (Jones tube) is placed from the inner eye corner to the nose.
Why: Provides a direct bypass when the natural channels cannot be salvaged.
Other procedures your surgeon may discuss include turbinate reduction (to make space at the duct exit), sac tumor removal, or dacryocystectomy (sac removal) in select cases.
Prevention tips
Wash hands often; avoid rubbing eyes.
Keep eyelid margins clean; treat blepharitis early.
Manage allergies (environmental control, nasal saline, clinician-directed therapies).
Treat sinus infections promptly to prevent scarring near the duct outlet.
Use preservative-free eye lubricants if you need frequent drops.
Practice safe cosmetic habits: remove makeup fully, don’t share products, replace mascara every 3 months.
Protect your face/eyes during sports and in risky jobs; wear seatbelts.
Avoid tobacco smoke and dusty environments when possible.
Follow post-procedure instructions carefully after any lacrimal or nasal surgery.
For babies: learn proper Crigler massage technique from your clinician; keep nails short to avoid skin injury.
When to see a doctor
Infants: tearing and discharge that persist beyond 6–10 months, or any red, swollen, tender lump at the inner corner at any age.
Adults: new or worsening tearing, recurrent “conjunctivitis,” painful swelling, fever, or pus when pressing the inner corner.
Any age: vision drop, bloody tears, after facial trauma, or after radioiodine or facial radiation therapy.
You should also see ENT if you have significant nasal blockage, frequent sinus infections, or nasal bleeding along with tearing.
What to eat—and what to limit
Helpful to include
Water throughout the day—keeps secretions thinner.
Fatty fish (salmon, sardines) 2–3×/week for natural omega-3s.
Citrus, berries, kiwi (vitamin C) to support collagen and healing.
Orange vegetables (carrots, sweet potatoes) and dark leafy greens (vitamin A/beta-carotene).
Nuts and seeds (vitamin E, zinc) for antioxidant and repair support.
Yogurt or fermented foods (probiotics) for immune balance.
Whole grains and legumes for steady energy and micronutrients.
Lean proteins (eggs, poultry, tofu) for tissue repair.
Spices like turmeric and ginger in cooking for gentle anti-inflammatory effects.
Limit highly processed foods to reduce systemic inflammation.
Consider limiting
Excess alcohol, which can dehydrate and worsen inflammation.
Very salty foods, which can worsen nasal and eyelid puffiness in some people.
Personal trigger foods that flare your allergies or reflux (these vary by person).
Tobacco smoke exposure (not food, but crucial to avoid).
Frequently asked questions
Will NLDO go away on its own in babies?
Many cases do. Most infants improve by 6–12 months with massage and hygiene. If it persists or infections occur, probing is considered.Can a blocked tear duct damage vision?
The blockage itself usually does not harm the cornea or retina, but recurrent infections can irritate the surface. Treat infections promptly.What’s the difference between dry eye and blocked tear duct?
Dry eye makes too few tears or poor-quality tears. NLDO makes normal tears that can’t drain, so eyes look watery. Some patients have both.Is probing painful for my baby?
Probing is quick and done with anesthesia (often brief general anesthesia in infants). Most children go home the same day.How successful is DCR surgery?
Both external and endoscopic DCR generally have high success in experienced hands. Your surgeon will discuss the expected rate for your anatomy.Can I just use antibiotics to fix NLDO?
Antibiotics treat infection, not the mechanical blockage. Procedures are often needed if the duct is truly scarred or closed.Do allergy medicines help NLDO?
They can reduce swelling at the duct exit and improve symptoms in partial obstruction or functional issues, but they do not remove a scar.Could my chemotherapy or radioiodine have caused my tearing?
Yes, some treatments can narrow canaliculi/ducts. Tell your ophthalmologist; imaging and targeted procedures can help.Are there drops to dissolve the blockage?
No proven drop dissolves a true scar. Avoid unproven “duct-opening” remedies.What are warning signs of serious infection?
Red, hot, painful swelling at the inner corner, fever, or feeling unwell—seek urgent care.Can canaliculitis be fixed with drops alone?
Often no; the concretions need mechanical curettage plus targeted antibiotics.Which is better—external or endoscopic DCR?
Both are effective. Endoscopic avoids a skin incision and addresses sinus disease; external gives direct sac access. Choice depends on your anatomy and surgeon expertise.Will a stent (silicone tube) be noticeable?
Usually not. A small loop may be visible at the inner corner. It is removed in clinic after the tissues heal.How soon can I go back to work after DCR?
Many return to light duties within a few days, avoiding heavy lifting and nose-blowing as instructed. Your surgeon will personalize this.Can diet or supplements open my duct?
No. Good nutrition supports healing and comfort, but procedures fix mechanical blockage.
Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.
The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members
Last Updated: August 14, 2025.
