Tear Sac Issues: Causes, Symptoms, and Solutions

The tear sac has turned into a water balloon?

I was born without a tear duct in my left eye, so tears continuously flow.
Previously, the area around my lacrimal sac was quite normal, similar to my right eye, but one day it suddenly started to hurt.
The pain radiated from my eye to my head, and when I touched the area around the lacrimal sac, it felt like a lump.
Later, that lump suddenly disappeared, and I noticed a small indentation in the bone near the bridge of my nose next to the lacrimal sac.
Since then, the lacrimal sac has felt like a water balloon.
I understand that without a tear duct, tears cannot drain into the body, but why are the tears getting trapped in the lacrimal sac? Shouldn't the lacrimal sac be empty? Is there a way to drain the fluid inside? If it is drained, will it accumulate again, or is it necessary to insert a tube? I am really afraid that if a tube is inserted, it might dislocate or break inside my eye, leading to blindness or something similar.

Pomi, 10~19 year old female. Ask Date: 2022/05/25

Dr. Cai Wenyuan reply Ophthalmology

It is recommended to seek medical examination.

Reply Date: 2022/05/25

More Info

Understanding tear sac issues, particularly in the context of congenital absence of the tear duct, can be complex and concerning. The tear sac, or lacrimal sac, is a crucial component of the tear drainage system. It collects tears from the eye and channels them through the nasolacrimal duct into the nasal cavity. When there is a congenital absence of the tear duct, as in your case, tears cannot drain properly, leading to excessive tearing and potential complications.

Causes of Tear Sac Issues
In your situation, the absence of the tear duct means that tears produced by the eye cannot be effectively drained away. This can lead to a buildup of tears in the tear sac, causing it to become distended or swollen. The sudden pain you experienced, along with the sensation of a "kernel" in the tear sac area, could indicate an infection or inflammation, such as dacryocystitis, which is an infection of the tear sac. This condition can occur when tears accumulate and create a breeding ground for bacteria.

Symptoms
Common symptoms associated with tear sac issues include:
1. Excessive Tearing: Continuous overflow of tears due to the inability to drain properly.

2. Pain and Discomfort: Pain in the tear sac area, which may radiate to the surrounding areas, including the head.

3. Swelling: A noticeable swelling or bulging in the tear sac area, which may feel like a lump.

4. Redness and Inflammation: The skin around the tear sac may appear red and inflamed, indicating infection.

5. Discharge: There may be discharge from the eye or the tear sac, especially if an infection is present.

Solutions and Treatment Options
Given your concerns about the tear sac and the potential for complications, it is essential to consult with an ophthalmologist or a specialist in ocular health. Here are some potential treatment options:
1. Warm Compresses: Applying warm compresses to the affected area can help relieve discomfort and promote drainage if there is any blockage.

2. Antibiotics: If an infection is suspected, your doctor may prescribe antibiotics to help clear the infection.

3. Surgical Intervention: In cases where the tear sac is chronically blocked or infected, surgical options may be considered. This could involve creating a new drainage pathway (dacryocystorhinostomy) or placing a tube to facilitate drainage. While concerns about the tube displacing or causing complications are valid, these procedures are generally safe and performed by experienced surgeons.

4. Tear Sac Aspiration: In some cases, aspiration of the tear sac may be performed to relieve pressure and remove accumulated tears. However, this is typically a temporary solution and may need to be followed by more definitive surgical intervention.

5. Regular Monitoring: Regular follow-ups with your healthcare provider can help monitor the condition and manage any complications that arise.

Conclusion
While the absence of a tear duct presents unique challenges, there are treatment options available to manage symptoms and prevent complications. It is crucial to address any pain or swelling promptly, as these can indicate underlying issues that may require medical attention. Consulting with a specialist will provide you with the best course of action tailored to your specific situation. Remember, early intervention can often lead to better outcomes and improved quality of life.

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