Eye Stent Can Help Treat Nasolacrimal Duct Blockage

An eye stent is a tiny tube made of silicone, metal, fabric, or plastic, which is surgically inserted in the affected site to clear an obstruction and keep the passage open for blood and fluids to pass smoothly.

Board certified ophthalmologist and oculoplastic surgeon Dr. Jennifer Hui provides advanced and proven eye care procedures to patients in Palm Springs, Palm Desert, La Quinta, Coachella Valley, Riverside, Redlands, Yucaipa, Loma Linda, and surrounding locations.

In a child with healthy eyes, the nasolacrimal duct allows the exit of tears from the eye by draining them into the nasal passage. If the child suffers from NLD condition, it means either the duct was closed at birth itself or has become blocked later. By the first year after the child’s birth, the NLD obstruction will typically open on its own.

If it fails to open, the eye surgeon can treat it with non-invasive or minimally invasive therapies. However, if the obstruction is tight or anatomic abnormality is present, the surgeon may decide to place a silicone stent to create the opening and enable better drainage. The procedure is usually performed with the child placed under general anesthesia.

Tears normally drain from the eye down the nose through the tear duct or nasolacrimal duct. If one looks in the mirror the openings of the tear ducts could be seen in the corners of the upper and lower eyelids. They look like 2 small dots, one in the upper lid, one in the lower lid and are called puncta. Tear duct obstruction prevents tears from draining through this system normally. If the tear duct is blocked, there will be backflow of tears and discharge from the eye.

The most common cause is a membrane at the end of the tear duct (valve of Hasner) that is present in about 50% of newborns but it normally disappears soon after birth. Other causes of blocked tear ducts in children include:

• Absent puncta (upper and/or lower eyelids)
• Narrow tear duct system
• Infection
• Incomplete development of the tear duct that does not communicate with the nose.

The principle behind the eye stent is similar to the ones used to prevent stroke and heart attack. Although eye stents are a highly advanced technology, their working is elegantly simple. When the natural drainage system of the eye gets clogged, an eye stent will create a new permanent access through the blockage to restore the eye’s natural fluid outflow. Once this mechanism is restored, the pressure buildup inside the eye will be lowered and the normal function will occur.

Nasolacrimal stents are small diameter tubes placed within the nasolacrimal system to maintain patency. The tubes are typically composed of silicone, or another similar semi-rigid yet flexible material with an open central lumen. Intubation of the nasolacrimal system is generally done temporarily, with stents remaining in place for several months. In rare instances, however, intubation may be long term. Nasolacrimal tubes are used primarily in cases of obstruction or laceration of one or more parts of the tear drainage system.