Tear Duct Surgery
Tear Duct Infection
A tear duct infection can cause a painful, red swelling at the inner corner of the eye, a sticky or watery eye, or repeated bouts of discharge. It can be uncomfortable and, understandably, worrying.
A tear duct infection often points to a blockage in the tear drainage system. Settling the infection is the first step; treating the underlying cause is what helps prevent it returning.
Dr Hannah Timlin is a consultant ophthalmic and oculoplastic surgeon with particular specialist expertise in tear duct surgery and lacrimal drainage disorders. She assesses and treats infections of the tear drainage system, and the underlying problems that cause them.
Consultant at Moorfields Eye Hospital · GMC 6134773 · Fellowship-trained lacrimal surgeon
At a glance
A quick summary of what a tear duct infection is, how it is treated and what to expect.
What is a tear duct infection?
A tear duct infection is an infection of the tear drainage system, which carries tears from the surface of the eye into the nose. Because tears normally keep this system flushed and clean, an infection often develops when tears are not draining as they should.
There are two main types. Dacryocystitis is an infection of the tear sac, the small reservoir at the inner corner of the eye. It can come on quickly, with a tender red swelling beside the nose, or it can be low-grade and recurrent. Canaliculitis is an infection of the fine channels that carry tears towards the sac, and can cause a red, sticky, repeatedly inflamed inner eyelid that is sometimes mistaken for conjunctivitis.
Identifying which part of the system is affected, and why, is important, because the right treatment differs between them.
Symptoms and when to seek help
The symptoms of a tear duct infection depend on which part of the drainage system is involved. Common features include a tender, red swelling at the inner corner of the eye, a sticky or discharging eye, watering, and infections that keep coming back.
Most tear duct infections are not emergencies and settle with prompt treatment. However, if the redness and swelling spread quickly, the eye becomes painful, your vision changes, or you feel unwell with a fever, this needs urgent medical attention, as the infection can spread to the surrounding tissues.
If you are unsure how serious your symptoms are, it is always safer to seek advice promptly.
Specialist lacrimal expertise
Tear duct surgery and lacrimal drainage disorders are one of Dr Timlin's core areas of expertise. She is a fellowship-trained lacrimal surgeon, and her research in this field has been recognised with national and international awards.
Because tear duct infections are so often linked to a blockage in the drainage system, they benefit from a surgeon who treats the whole lacrimal pathway, not just the infection itself. Dr Timlin assesses why the infection has happened and how best to prevent it returning.
This sits within a broader oculoplastic practice. She is an experienced consultant who also performs blepharoplasty, ptosis (droopy eyelid) surgery, eyelid malposition surgery and periocular reconstruction, and she manages the full range of eyelid and tear duct conditions.
Why tear duct infections happen
Tear duct infections usually happen when tears are not draining freely. When the tear duct becomes narrowed or blocked, tears and debris can collect in the tear sac, creating conditions in which infection can develop.
A blocked tear duct is the most common underlying cause of dacryocystitis, and is often related to age-related narrowing of the drainage pathway. In canaliculitis, small soft stones can form within the tear channels and harbour infection.
This is why treating an infection in isolation is often not enough. Unless the underlying drainage problem is addressed, infections can return.
Treating a tear duct infection
Treatment usually has two parts: settling the active infection, and then dealing with the underlying cause to reduce the chance of it coming back.
Settling the infection
An acute infection is usually treated first with antibiotics, sometimes alongside warm compresses. If a collection of pus (an abscess) has formed, it may need to be drained. The priority at this stage is to bring the infection under control safely.
Treating the underlying blockage
Once the infection has settled, attention turns to why it happened. If there is a blocked tear duct, the usual treatment is dacryocystorhinostomy (DCR), an operation that creates a new drainage channel between the tear sac and the nose, allowing tears to drain freely again. You can read more about watery eyes and blocked tear ducts.
Treating canaliculitis
Canaliculitis is treated by clearing the affected tear channel, which usually means removing the material and any small stones causing the infection, sometimes with a minor procedure. This often resolves symptoms that have persisted despite repeated courses of drops.
When further treatment is not needed
Not every patient needs surgery. Some infections settle fully with medical treatment, and the right plan depends on the cause, how often infections occur and how much they affect you.
Infections that keep coming back usually have a treatable underlying cause. A specialist assessment will find it, with no pressure to proceed.
Book a ConsultationYour consultation
Your consultation begins with a discussion of your symptoms, including any swelling, discharge, watering or previous infections, and how often they occur.
Dr Timlin will examine your eyelids, the inner corner of the eye and the tear drainage system, and may gently check how your tear ducts drain. Where it will help, she can arrange further tests or imaging of the tear ducts to understand the underlying problem.
She will then explain what she has found, what is causing your infections, and the options available, including the likely benefits, limitations, risks, recovery and fees, so you can make an informed decision.
Recovery
Recovery depends on the treatment. An acute infection treated with antibiotics usually improves over several days, although the underlying cause may still need attention afterwards.
If tear duct surgery such as DCR is needed, it is usually a day-case procedure. It is common to have some bruising, mild swelling and a blocked or blood-tinged nose for a short period, and most patients return to desk-based work within around one to two weeks.
You will be given clear aftercare advice covering medication, wound care where relevant, and what to expect as you heal.
Risks and realistic expectations
Most tear duct infections respond well to treatment, particularly when the underlying cause is addressed. As with any condition, however, outcomes vary from person to person and cannot be guaranteed.
Infections can occasionally recur, especially if a drainage blockage is not treated. Tear duct surgery carries its own small risks, including bleeding, infection and, in a minority of cases, the need for further surgery, and these are discussed fully before any procedure.
Dr Timlin will explain what treatment can realistically achieve in your situation, and which risks are most relevant to you, so that your expectations are clear.
Fees and insurance
Assessment and treatment of a tear duct infection is usually functional rather than cosmetic, because it addresses a medical problem. For this reason it is often eligible for cover by private medical insurance, subject to your policy and your insurer's criteria.
Self-pay treatment is also available. Fees depend on the treatment recommended, whether surgery is required, the type of anaesthetic used and hospital fees. Where a blocked tear duct needs DCR surgery, fees typically range from £4,000 to £7,500 as a guide. Full guide prices are published on the patient information page.
After your consultation, you will receive a personalised treatment plan and quotation explaining the recommended approach, the expected costs and what is included.
Treatment for tear duct infections is often covered by private medical insurance. Fee guidance is available when you book.
Book a ConsultationTear duct infection FAQs
Dacryocystitis is an infection of the tear sac at the inner corner of the eye, usually caused by a blocked tear duct. It often causes a tender red swelling beside the nose, along with discharge and watering.
Most tear duct infections settle well with prompt treatment. However, if the redness and swelling spread quickly, the area becomes very painful, or you feel unwell with a fever, this needs urgent medical attention.
Recurrent infections usually point to an underlying blockage in the tear drainage system, where stagnant tears allow infection to develop. Treating the blockage is what reduces the chance of infections returning.
Antibiotics usually settle the acute infection, but they may not prevent it returning if there is an underlying blockage. In that situation, treating the blockage is often needed as well.
Not always. Some infections settle with medical treatment alone. Where a blocked tear duct is the cause, surgery such as DCR is often recommended to restore drainage and reduce recurrence.
Canaliculitis is an infection of the fine channels that carry tears towards the tear sac. It can cause a red, sticky, repeatedly inflamed inner eyelid, and is sometimes mistaken for conjunctivitis. It is treated by clearing the affected channel.
Treatment of a tear duct infection is usually functional rather than cosmetic, so it is often eligible for cover by private medical insurance. Self-pay treatment is also available, with a personalised quotation after your consultation.
No referral is needed for self-pay consultations; you can book directly. If you hope to use private medical insurance, your insurer may require a referral and supporting information before approving cover.
Book a Consultation
If you have a painful swelling at the inner corner of your eye, a persistently sticky eye, or infections that keep returning, a specialist assessment can identify the cause and the right treatment.
Dr Hannah Timlin will assess your eyelids, eye surface and tear drainage before advising on the safest, most effective approach for you.
Reviewed by Dr Hannah Timlin, Consultant Ophthalmic and Oculoplastic Surgeon (GMC 6134773). For general information only, not medical advice.