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Thread: Blocked tear duct- surgery?

  1. #1

    Join Date
    May 2007
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    Brisbane, Queensland
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    Default Blocked tear duct- surgery?

    Hi, My DD has had blocked ducts since birth. The R side unblocked at 6 months. The Left side is still blocked she is now 15 months. I saw a paediatric opthamologist who has booked us in for probe surgery in June. I would like to hear of anyones experience with the same.
    The Dr said its my choice but didnt really explain side effects or what will happen if i dont go ahead with it. My GF in NZ said they dont do probe surgery anymore and her daughters unblocked finally at 3 years old.
    It has improved a little in the last month- I no longer need to wipe the gunk from her eye constantly, though it still tears up and runs down her face.
    Anyone who has had the probe, or decided to not do the surgery, I would appreciate any comments. Please dont bother posting your advice on breast milk in the eye-it is not an infection, and unless you feel massage has made a significant difference, I know all about that too!!



    Thanks

  2. #2

    Join Date
    Aug 2005
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    Melbourne, Victoria
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    Default

    Hi,

    Just replying quickly to let you know i've seen your post. My DD also had blocked tear ducts from birth. We had our first probing at 10 months, and had to have it repeated at 15 months. We now need to have further surgery in the next few months. This is very uncommon, it was only after the 2nd surgery that we found out she didn't have properally formed tear ducts.

    My DH just got home from work now, so i have to run, but i would make the same choices again, and if she is 1 and it hasn't unblocked then i would seriously consider the surgery.

    Will be back later to write more

  3. #3

    Join Date
    May 2007
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    Brisbane, Queensland
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    Default

    Thanks, waiting patiently for more info!!

    Why do you recommend the surgery? I am worried about the general anaesthetic and hospital experience for my DD. (and I am a nurse so I am well aware of what to expect). I was at the opthamologist office for 2 hours, saw 3 people- the opthamologist for about 5 mins only. He didnt give me chance to ask questions. I believe it will unblock by itself eventually, so I wonder about putting her through it all with a chance of it not even working. Why have you gone through it 3 times? Is it because of the abnormality to the formation?
    Any more info would be great

    Thanks

  4. #4

    Join Date
    Jan 2006
    Location
    country victoria
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    Hi

    My eldest son had a blocked tear duct, we waited quite a while to see the eye surgeon in the hope that it would unblock itself. By the time we had referral and then got in to see him my son was 2 years of age. His eye was constantly watering and whenever he had a cold would have a discharge coming from it.

    He had the surgery when he was just over 2, was a very simple straightforward procedure, was probably only under anaesthetic for about 10 mins. The minute he came too in recovery one of us was allowed up there to be with him. He didn't have a bad reaction. He came back down to his bed, was a bit sleepy, then had some food to eat and watched Hi 5. By about lunch time we were allowed to leave. You wouldn't have even known he had just had surgery he was fine. And his eye was great. The surgeon actually commented that he had 3 blockages so I was glad it was done as they wouldn't have unblocked on their own.

    Anyway approx 7 months later when he his first major cold since the probe I noticed the discharge was back (although not as bad) and also eye was watering again slight. Rang eye surgeon he was great and saw as that week. He said that his ducts were narrow and that could look at doing another probe but also suggested trying rhinocort first just to see if that helped before doing surgery. Surgery was booked for about 3 months down the track but by then his eye was fine and has been ever since.

    I am glad that he had the op and can honestly say that he has not been traumatised by it at all.

    Good luck in making your decision, it is always hard to know what it best.

  5. #5

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    DD's ducts were both blocked from birth, one cleared at 9 months, the other is watery 1 day in 7 now at eighteen months, if that.

    I was encouraged to get the second one looked at after a 12 month appointment with the MCHN. We weighed up the options and decided to wait a while longer, given that she had grown through the first one without interference.

    Had neither of them improved I would not have hesitated to investigate durgical options further but this was not the case.

    Not an easy decision - I can only wish you the best of luck as you proceed.

  6. #6

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    My DD had both tear ducts blocked from birth. One cleared by itself at about 6 months and the other spontaneously at 14 months.

    I was very keen to avoid a probe as I had heard that they often clear by themselves at about 12 months. I was pretty upset that that didn't happen for poor DD at 12 months as I thought it meant a probe. I decided that since the blockage didn't seem to be causing her any distress, it would not hurt to leave it for a little longer and to keep massaging it daily. I just kept hoping that she was suffering from the "grow into their ducts" problem. This is how it turned out for us luckily. One day I realised that I had not had to wipe her eye for a few days and have not had to do so since.

    It is a really difficult decision to make as we all want to avoid unnecessary surgery but it seems that only hindsight will really tell you whether you have done the right thing. If there was an easy way to know whether your child is one of those with tear ducts which are not properly formed, that would make all the difference.

    Good Luck.
    I

  7. #7

    Join Date
    Aug 2005
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    Melbourne, Victoria
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    Hi everyone,

    Ok, back finally (apologies about the long delay, we are dealing with a lot of other health issues with my DD at the moment, so my time is tight)

    Ok, so my daughter had crusty, weeping eyes literally from day 1. The nurses said it was very early for it to be like that, but we went on doing the saline & cotton wool wipes etc, rubbing nose, b/m etc.

    FF to around 4 months, by this stage she had already had antiobiotic eye drops a few times because they were getting infected. The tear constantly, not as much as she is crying but every few mins is having tears roll down her face. Around her eyes she is constantly red and blotchy looking. When they are infected it is that green/yellow goopy conjuncitivis look.

    Asked Gp for a referral, and went to see an paediatric opthamologist. She was great, said they were pretty watery, but suggested that we wait until 1 year. She said the majority of cases resolve themselves by then, as most of the time it is caused by narrow tubes and when the babies face grows they widen and the blockage can drain into the nose. She did say if the constant cleaning (when they are bad it is around 3 times a day i'm holding her down washing her eyes with saline), then she would probe earlier.

    We decided to wait and see what would happen, but after quite a few more infections we went back at 9 months, and they were probed at 10 months. I was just getting sick of all of the infections, and she was having bad reactions to the eyedrops (everyone (paed, gp) thought i was insane for suggesting she was allergic to the eyedrops, the opathamologist said she trusts mother instincts so was inclined to believe me, and recently when we had her allergy tested she is allergic to the eyedrops).

    The first probing was pretty good. We had it done at the childrens, where they are great at anathetising children. It was a very very light GA, so much so that she was already awake by the time we walked from the waiting room into recovery. One side was probed fine. Basically there are 2 chanels running from above and below that pink corner of your eye, the botom one takes about 90% of tears, the top one 10%.. These chanels merge into one tube, which end in the nasal cavity. They stick the probe down so that they can see the probe popping out into the nasal cavity. The 2nd side they found out she had a birth defect (not very common, and we have a family history of something associated with it). It meant that she had an extra sinus just below her eye, so a hole along the chanel so not everything ran into the main drain. The surgeon couldn't get the probe past this fissure, and so couldn't do the probing on that side.

    We were referred off to 2 surgerons, ENTs who do plastic surgery, and on the side run once a month a clinic where all the opthamologist send the problem tear duct cases. This was done almost 6 months later. When they stuck the cameras up the nose, they found out that my daughter didn't really have an exit hold into the nasal cavity, it just ended in a sack. They cut that open, made new holes, and drained the blockage. They said heaps of pus and gunk came out. She never had a chance of them unblocking. Even with the birth defect, this formation of the tear ducts is heard of, but pretty rare. Now we are having a lot less tearing & infections, but still some, and i think it is getting worse, so we are looking at further surgery within the next 4 months and this time they will probably put in plastic tubes to widen and create a tear duct.

    Ok, so things to think about.
    1) It depends where the blockage is, close to the eye or close to the nose. You can try the massage, but both surgerons have said most people don't know how to do it properally so it is generally pretty ineffective, and it might not work anyway.
    2) how much tearing/infections the child has. Constantly fighting low grade infections in the eyes isn't generally good for the general health of a growing child. It is not assocaited with any long term damage to eyesite though.
    3) there is a chance they can pick up a nasty infection through the eyes - in 3rd world countries they probe at birth to avoid this... rare here, but can happen (chicken pox for example can be caught through the eyes)
    4) - IMPORTANT - the sucess of the surgery working is significantly higher the earlier it is done. I guess the general feeling is that if it hasn't unblocked naturally by 12 months, it is less likely to, and this has to be weighed up with waiting and then possibly needing more extensive tear duct surgery (2nd probing, tubing followed by creating entirely new ducts).

    In general it has a 90% sucess rate for the first probing, followed by 80% for the 2nd.

    I think it is something you have to weigh up on your own. For us, the constant infections, and obivous bad blockage outweighed the risk of a very light GA. As much as there is a risk from GA, this is still a very very small risk (they didn't tube her the first time, only the 2nd).

    Ok, hope that helps, if i think of anything else or you have any more questions, please ask.

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