Lacrimal probing offers effective relief for patients suffering from blocked tear ducts, enabling better eye drainage and comfort. Our skilled eye professionals will assess your condition to determine the best course of action.
Lacrimal probing helps clear the tear duct so tears can drain properly. It opens a small channel from the corner of your eye to your nose. This procedure can reduce watering and discharge, making your eyes more comfortable.
Before talking about lacrimal probing, it helps to know how the tear duct works. Tears drain from tiny openings in the inner eyelids, through a bony channel, and into the nose. Sometimes this duct doesn’t open at birth. It usually clears up on its own, but if it stays blocked, mucus can build up. This can lead to constant tearing, red eyelids, and mild infections like conjunctivitis. While uncomfortable, it rarely affects vision or overall eye health—serious issues like acute dacryocystitis are uncommon.
Most blockages go away without treatment. Even in older kids, the duct can clear on its own. Probing is usually considered when the blockage doesn’t resolve, especially after age one. The procedure works best before age four, so earlier decisions are more effective.
If your eye constantly waters or feels irritated, your tear duct might be blocked. Lacrimal probing is a simple procedure that clears the blockage and helps your eye drain properly again.
You might need it if:
Probing is quick and usually done in the clinic. It doesn’t take long, and most people recover fast. Our eye doctor will check if it’s the right step for you.
If you're unsure, ask. It's better to fix the issue early than let it get worse.
First, we explain the procedure and get consent. It’s important that the patient feels informed and at ease. After washing hands and putting on gloves, the patient is asked to lie back in a comfortable chair or on an exam bed, with their head supported at about a 45-degree angle. Proper positioning helps make the procedure go smoothly.
A clean towel is placed across the neck to catch any fluid, and we use good lighting—ideally an overhead lamp—to see the tear duct area clearly.
We place numbing eye drops into both eyes and directly over the tiny tear duct opening (called the punctum). We wait about 30 seconds for the area to go numb. While waiting, we check the tools: the dilator must be clean and undamaged, and we prepare a syringe filled with sterile salty water (saline), with a soft tube (cannula) attached.
This setup helps make the process as smooth and comfortable as possible.
Once the area is numb, we gently pull down the lower eyelid using a piece of gauze to find the punctum. Then, we insert the clean metal rod (called a Nettleship dilator) into the opening. First, it goes straight down about 2 mm, then we rotate it gently to help it move through the narrow channel.
Next, we gently pull the eyelid sideways to straighten the tear duct path and move the dilator further in, this time more horizontally. This step makes it easier to insert the cannula in the next part.
After dilating the duct, we insert the cannula into the same opening. With the eyelid still gently pulled sideways, the cannula is guided along the tear duct until it stops—either softly (like a sponge) or firmly (like bone). This helps us figure out where any blockage might be.
Then, we pull the cannula back slightly (about 2 mm) and slowly inject the saline. The patient may taste something salty at the back of their throat—this is a good sign.
As we inject the saline, we watch how easily the fluid flows. If the patient tastes salt, it means the saline made it all the way through the duct into the nose, showing the duct is open. We also check the upper eyelid opening to see if any fluid comes back out.
If the patient doesn’t taste anything, it could mean the duct is still blocked. And even if everything seems clear during the flush, there could still be a minor blockage that only causes symptoms during normal tear flow.
Lacrimal probing is performed to actively address the symptoms associated with a blocked tear duct. When successful, the procedure can significantly reduce the extent of constant tearing and discharge. This leads to more comfortable eyelids and a lower risk of developing infections such as infective conjunctivitis. It is also a relatively straightforward procedure that can be performed in an office setting, often without the need for extensive surgical intervention.
In many cases, the probing helps resolve the inconvenience of watery eyes, allowing patients, especially young children with persistent symptoms, to experience relief. Our eye doctors take pride in the meticulous yet gentle approach they use during the procedure, combining technical precision with a caring attitude. Even when the system is shown to be patent under test conditions, the probing provides valuable information on whether additional functional testing might be required. The insights gained from lacrimal probing can guide further decisions regarding patient care, ensuring that each individual receives tailored advice for optimal eye comfort.
The outcome of lacrimal probing helps decide what to do next. Here’s what the results usually mean:
This shows the saline reached the nose, meaning the tear duct is open under test conditions. But this doesn’t rule out a functional problem—where the duct works during the test but not in daily life. In those cases, the eye may still water too much (called epiphora). To check for this, more tests like the Jones test or lacrimal scans might be needed.
If you’re experiencing persistent tearing or irritation, don’t hesitate to consult with a top optometrist or ophthalmologist. Practices listed with Specialty Vision offer expert lacrimal probing services tailored to your needs.
This points to a blockage somewhere in the tear duct. We figure out where the blockage is by how the cannula feels during the test:
We also check for fluid coming back out of the upper tear duct opening:
The procedure works by gently opening or widening the tear duct, which allows tears and mucus to exit the eye more freely. This reduction in stagnation can help ease symptoms like continuous watering and potential irritation.
Because local anaesthetic eye drops are used to numb the punctum and adjacent structures, most patients experience little to no pain during the procedure. Our eye doctors take great care to ensure comfort throughout the process.
If the probing suggests a functional obstruction or if the blockage persists despite a successful saline flush, further tests may be recommended. These additional procedures help in determining a more precise cause of the tearing, thereby guiding any further treatment options.
The likelihood of success is highest when the procedure is performed early, before the age of four years. With proper technique and in appropriately selected cases, lacrimal probing can be very effective in relieving symptoms.
If you’re experiencing persistent tearing or irritation, don’t hesitate to consult with a top optometrist or ophthalmologist. Practices listed with Specialty Vision offer expert lacrimal probing services tailored to your needs.
Lacrimal probing is a procedure that helps clear tear duct obstructions, improving eye drainage and comfort.
