How Tear Duct Irrigation and Imaging Confirm Where the Blockage Sits

Maria noticed it first on cold mornings. One eye would brim over on the walk to the bus stop, and by the time she reached her desk the skin at the inner corner was raw from tissues. Reading glasses did not help. Neither did the drops she picked up for dry eye, which felt odd, because her eye was anything but dry. When she finally saw an eye specialist, the answer to “what is wrong” turned out to be less useful than the answer to “where.” That is the whole job of a blocked tear duct test.

Tears leave the eye through a plumbing system barely wider than a human hair in places. A block at the top behaves differently from a block at the bottom, and the plan that follows depends entirely on the level. So the examiner does not just look; the examiner flushes, times, and sometimes photographs the pathway with dye.

This explainer walks through each of those steps, what the results mean, and which questions are worth asking before anyone books a procedure.

What does a blocked tear duct test actually check?

Start with the plumbing, because every test is designed around it. Tears are made in the lacrimal gland, which sits under the outer part of the upper eyelid. Each blink sweeps them across the eye toward the nose. At the inner corner of each eyelid there is a tiny opening called a punctum, one on the upper lid and one on the lower. Tears pass through the puncta into the canaliculi, thin channels running under the lid skin. The upper and lower canaliculi usually merge into a common canaliculus that empties into the lacrimal sac, a small pouch beside the bridge of the nose. From the sac, the nasolacrimal duct runs down through bone and opens inside the nose. That is why a good cry makes your nose run.

A blockage can sit at any of those five stations: the punctum, a canaliculus, the common canaliculus, the sac, or the nasolacrimal duct. Whatever the level, the visible result is the same. Tears back up and spill over the lid margin, a symptom clinicians call epiphora. Mayo Clinic notes that overflow, crusting, and sometimes mucus or repeated infection are the usual reasons people are referred for testing.

The examiner’s task is therefore not to prove that tears are overflowing. You already know that. The task is to establish the level of the block, whether it is complete or partial, and whether the passages are anatomically closed or simply pumping poorly. Those three answers drive everything that follows, from watchful waiting to a surgical bypass. A blocked tear duct test is really a set of small, sequential tests, each ruling in or out one part of the pathway, and most people go through only the first two or three.

How the tear duct flushing procedure works, step by step

The tear duct flushing procedure, which specialists call lacrimal irrigation or syringing, takes place in an ordinary exam chair. Nobody changes into a gown. First come numbing drops, so the surface of the eye and the inner lid feel little more than pressure. The examiner then uses a fine, smooth instrument called a punctal dilator to widen the lower punctum for a few seconds. Many people describe this as a firm nudge rather than pain.

Next, a blunt-tipped cannula, a very thin hollow tube with no sharp edge, is slid a short distance along the lower canaliculus, following the natural curve of the channel. A syringe of sterile saline is attached, and the examiner pushes the fluid slowly while watching the eye and asking you to report what you feel. Two sensations matter. One is a salty taste or trickle at the back of the throat, which means fluid has traveled the full length of the system and reached the nose. The other is fluid welling back out around the eye, which means it met resistance somewhere.

The whole thing typically takes a few minutes per side, according to Mayo Clinic’s description of the diagnostic workup. Your job is to keep still, look in the direction requested, and swallow when you notice the salt. The examiner’s job is to notice the pressure needed, the amount and character of any reflux, and exactly which opening it comes from.

Irrigation is a diagnostic act, not a repair. Occasionally a soft plug of mucus is dislodged and the watering eases for a time, which can be pleasant but should not be mistaken for a fix. The point of the flush is information, and the information sits in what comes back.

Reading the flow: what saline reflux reveals about the block

Think of the system as a Y-shaped pipe lying on its side. Saline goes in at one arm of the Y. Where it exits tells the examiner which section is closed.

• Fluid reaches the throat freely, nothing comes back. The passage is open all the way to the nose. If tears still overflow, the problem is likely functional (see the Jones tests below) or lies at the surface of the eye rather than in the duct.
• Fluid refluxes from the same punctum it entered. The block is in that canaliculus, before the channels merge. The rest of the system has not been tested yet, so the examiner often repeats the flush through the upper punctum.
• Fluid refluxes from the opposite punctum. Saline went down one canaliculus, across the common channel, and up the other. The canaliculi are open; the block is lower, in the sac or nasolacrimal duct. If the reflux is cloudy or contains mucus, the sac is probably stagnant and distended.
• Some fluid reaches the throat, some refluxes. A partial or narrowed passage, common in age-related nasolacrimal duct obstruction.

Many examiners also advance a fine probe gently to feel for the end point. A firm, immovable end, called a hard stop, means the probe has reached the bony wall of the lacrimal sac and the canaliculi are open. A spongy, yielding end, a soft stop, means the probe is pushing against a closed canaliculus. The National Library of Medicine’s clinical summary describes this hard-versus-soft distinction as central to separating upper-system from lower-system blockage.

The examiner writes all of this down in shorthand that can look cryptic on a report: “patent to irrigation,” “reflux via opposite punctum with mucoid material,” “hard stop.” Ask for the translation. Each phrase points to a level, and the level points to a plan.

The fluorescein dye disappearance test: the simplest blocked tear duct test

Before anyone reaches for a cannula, most specialists run the gentlest blocked tear duct test there is. A drop of fluorescein, a harmless orange dye that glows yellow-green under blue light, is placed in each eye. You sit and blink normally. The examiner then looks at the tear film through a cobalt-blue filter and watches how quickly the color fades.

In an eye with normal drainage the dye is largely gone within about five minutes, cleared down the duct with the tears. The National Library of Medicine’s clinical summary notes that dye still pooling along the lid margin after that window suggests obstruction. Comparing the two eyes side by side is the real strength of the test: a bright meniscus on one side and a faint one on the other is hard to miss.

Why start here? Three reasons. Nothing enters the duct, so the test is comfortable enough for toddlers and anxious adults. It reflects how the system works during real blinking, not under the artificial pressure of a syringe, so it can flag a functional problem that irrigation would miss. And it is quick, leaving time in the same visit for the flush if needed.

What it cannot do is tell you where the block is. Slow clearance is a yes-or-no signal for the whole pathway. A punctum narrowed by years of blepharitis, a canaliculus scarred after an infection, and a nasolacrimal duct closed by chronic inflammation all produce the same lingering glow. That is precisely why the dye test is a first step rather than the last, and why a report that says only “delayed dye disappearance” is an invitation to further testing, not a diagnosis of any particular level.

Jones tests: is the tear duct closed, or just pumping poorly?

Here is a distinction many people never hear explained. An anatomical block means the passage is physically narrowed or sealed. A functional block means the passage is open but tears still do not clear, usually because the pump has weakened. The pump is the blink itself: with each closure, the muscle around the eye squeezes the lacrimal sac and draws tears down. Loose lower lids, weak facial muscles after Bell’s palsy, or a punctum that has rolled away from the tear film can all leave an open duct that simply does not drain well.

The Jones tests were designed to separate these two situations, and they build directly on the dye test. In the primary Jones test, fluorescein is placed in the eye and, after a few minutes of normal blinking, a small cotton swab is placed just inside the nostril at the point where the duct opens. Dye on the swab means tears are traveling the full route under their own power; the system is both open and working. No dye means either a block or a weak pump, and the test moves to its second stage.

In the secondary Jones test, the residual dye is rinsed from the eye and the duct is irrigated with clear saline, exactly as described above. The examiner then checks what arrives in the nose. If the fluid recovered is tinged with dye, tears had reached the lacrimal sac during normal blinking but could not pass beyond it: a partial or functional problem in the lower system. If the fluid is clear, dye never entered the sac at all, pointing to the punctum or canaliculi.

The Jones tests are fiddly and not every clinic uses them, but they answer a question that a plain flush cannot. An open duct on irrigation does not rule out a drainage problem; it only rules out a closed one.

When is a dacryocystography scan added?

For most adults, the dye test plus irrigation settles the level and no imaging is needed. A dacryocystography scan, usually shortened to DCG, is brought in when the picture is murky or when surgery is on the table and the surgeon wants a map before making an incision.

The procedure begins like the flush. After numbing drops and gentle dilation, the cannula is placed in the canaliculus. This time, instead of saline, a small volume of contrast agent, a liquid that shows up white on X-ray, is injected. Images are then taken with either plain X-ray or, more often now, a CT scanner that reconstructs the pathway in fine slices. Because the contrast follows the same route as tears, the resulting picture is a silhouette of the duct itself: where it is wide, where it pinches, and where it stops.

DCG answers questions irrigation cannot. Is the lacrimal sac enlarged and baggy, suggesting long-standing stagnation? Is there a stone, called a dacryolith, inside it? Does the duct narrow gradually or end abruptly? Is there an outpouching, a diverticulum, that might trap tears? The National Library of Medicine’s clinical summary lists DCG among the imaging studies used to define anatomy before surgical planning, particularly when a bypass operation called dacryocystorhinostomy is being considered. That operation creates a new opening from the sac directly into the nose, and knowing the sac’s size and position beforehand matters.

What DCG shows less well is function. Contrast is pushed in under pressure, so a duct that looks open on the film may still fail under the softer force of a blink. That is why DCG is often paired with a functional study rather than used alone, and why a normal-looking scan does not end the conversation if the eye is still watering.

Dacryoscintigraphy, CT and MRI: what each image shows

Three other imaging tests appear in specialist reports, each with a different question in mind.

Dacryoscintigraphy is the functional counterpart to DCG. A drop containing a tiny amount of radioactive tracer is placed in the eye, nothing is injected, and a gamma camera follows the tracer as blinking carries it toward the nose. The result is a moving picture of drainage under physiological conditions. It is the test most likely to reveal a functional block, where anatomy looks fine but transit is slow. Resolution is low, so it shows delay rather than precise structure.

CT without lacrimal contrast is ordered when the bone or sinuses are suspected. The nasolacrimal duct runs through a bony canal beside the maxillary and ethmoid sinuses. Old facial fractures, chronic sinus disease, previous nasal surgery, or a mass pressing from the sinus side can all narrow that canal. CT shows bone crisply and helps a surgeon judge how much drilling a bypass would require.

MRI is reserved for soft tissue concerns. If the lacrimal sac area is swollen but not tender, if bloody tears have been reported, or if the block sits unusually high in the sac, the clinician may want to exclude a growth in or around the sac. MRI shows soft tissue better than CT and does not use radiation.

Ultrasound occasionally appears, mainly to check whether a swelling beside the nose is fluid-filled sac or something solid.

None of these is routine. Mayo Clinic’s description of the diagnostic pathway makes clear that most people are assessed with the dye test and irrigation alone, and imaging is added selectively. If a scan is proposed, the useful question is not “which one is best” but “which question is this scan meant to answer.”

Nasal endoscopy: checking where the tears are supposed to exit

Tears leave the body inside the nose, beneath a ridge of tissue called the inferior turbinate. A block at the very bottom of the system can be invisible from the eye side and obvious from the nose side, which is why many oculoplastic and ear-nose-throat specialists finish the assessment with a look inside.

Nasal endoscopy uses a slim, rigid or flexible telescope with a light and camera at the tip. After a decongestant and numbing spray, the scope is passed a short way into the nostril while you sit upright. Most people feel pressure and an urge to sneeze rather than pain, and the examination is over in a couple of minutes.

The examiner is looking for anything that could crowd the exit. A deviated septum pressing against the turbinate. Nasal polyps. Scar tissue from earlier sinus or nasal surgery. Swelling from chronic rhinitis that has narrowed the space where the duct opens. Rarely, a growth. If a previous bypass operation has been performed, endoscopy also checks whether the new opening is still patent or has closed over.

Endoscopy pairs naturally with irrigation: saline or fluorescein can be flushed from the eye while the scope watches the nasal exit, confirming in real time whether anything arrives and how freely. Some clinicians perform this combined check on everyone being considered for surgery, because it turns two indirect clues into one direct observation.

The NHS notes that a blocked tear duct in adults may result from inflammation, infection or injury involving the nose and sinuses, and endoscopy is how that side of the story gets examined. Ask whether the exit has been looked at, not just the entrance. A watering eye is sometimes a nasal problem wearing an eye problem’s clothes.

Who is usually tested, and who is usually asked to wait

Testing makes sense when the answer will change the plan. The adults most often sent for a full workup have persistent overflow in one or both eyes that has not settled, mucus or crusting at the inner corner, a history of one or more sac infections, or watering that began after facial injury, nasal surgery, or a course of certain cancer treatments known to scar the duct. Anyone being considered for a bypass operation is tested first, because the surgeon needs the level confirmed.

Several groups are commonly asked to wait, and the reasons are practical rather than dismissive.

• Newborns and young infants. Mayo Clinic notes that blocked tear ducts are common in babies and that most open on their own during the first year of life. Irrigation and imaging are rarely performed in an awake infant; the dye test and a careful look are usually enough for now.
• Anyone with an active sac infection. Dacryocystitis, a painful red swelling over the lacrimal sac, is treated first. Pushing fluid through an infected sac can drive bacteria into surrounding tissue, so irrigation is deferred until the inflammation has settled.
• Recent facial trauma or nasal surgery. Swelling can mimic obstruction. Many specialists reassess once healing has finished.
• People whose watering is reflex tearing from a dry or irritated surface. The NHS points out that watering eyes are often caused by irritation or dry eye rather than a drainage block. Treating the surface first can make the duct test unnecessary.

Being asked to wait is not the same as being told nothing is wrong. It usually means the examiner expects the picture to change, or wants to remove a confounder before committing you to a test whose result might otherwise be misleading. The decision about timing, like every decision here, sits with the treating team.

Nasolacrimal duct obstruction diagnosis in babies: what is different

Parents often arrive expecting the same flush an adult would have. Nasolacrimal duct obstruction diagnosis in infants follows a different logic, because the cause is usually different and the child cannot report a salty taste.

In most babies the block is a thin membrane at the lower end of the duct that did not open before birth. Mayo Clinic describes the typical picture: a constantly wet eye from the first weeks of life, sticky discharge that collects on the lashes, and skin that may look sore, in an otherwise comfortable child with a white, calm eyeball. The diagnosis is largely clinical. The examiner looks at the lid position, checks that the puncta are present, and presses gently over the lacrimal sac beside the nose. Mucus welling up from the punctum when the sac is pressed is a strong sign of a lower block with an open upper system.

The fluorescein dye disappearance test adapts well to infants because it requires nothing more than a drop and a light. Persistent dye after several minutes, compared with a clearer fellow eye, supports the diagnosis without any instrument entering the duct.

Irrigation and imaging are generally avoided in awake babies. When the block has not opened with time and gentle massage, and the child is old enough, a probing procedure under general anesthesia both confirms and treats the obstruction: a fine probe is passed down the duct to open the membrane, and saline is then irrigated to confirm flow. That is a treatment decision made by the child’s eye specialist based on age, symptoms and infections, and it is not made at the first visit.

Two features change the picture and prompt earlier, wider assessment: a bluish swelling below the inner corner present from birth, called a dacryocystocele, and any redness, heat or fever suggesting infection. Those are discussed under red flags below.

What the following hours and days usually look like after irrigation or imaging

People are often surprised by how little happens afterward. The numbing drops wear off within the hour, leaving a scratchy or slightly bruised feeling at the inner corner that eases by evening. If fluorescein was used, the tear film may look faintly yellow for a while and a tissue dabbed at the eye can come away tinged. Contact lens wearers are usually asked to leave lenses out until the dye has cleared, since soft lenses can absorb the color.

If saline reached the nose, expect a salty, slightly stuffy sensation and the occasional need to blow. After a dacryocystography scan, the nose may feel congested for the rest of the day, and a small streak of blood-tinged mucus on blowing is not unusual because the contrast has passed through irritated lining. Most examiners advise against forceful nose-blowing for the remainder of that day and suggest avoiding eye makeup until the next morning so the punctum is not disturbed.

Driving is generally fine once vision has cleared from the drops, though many people prefer to be driven if their pupils were dilated for a separate retinal check during the same visit. Ordinary work, screens and reading can resume immediately.

Results from the flush and dye test are usually discussed in the room, and you should leave with a clear sentence about the level: open, partial, upper-system or lower-system. Imaging reports go to the referring specialist and are explained at a follow-up. If the block has been confirmed and a procedure is being considered, that appointment is where options, risks and alternatives get laid out, and where you can bring the questions listed further down.

Watering itself may briefly improve after a flush if mucus was dislodged. Enjoy it, but note when it returns; that timing is useful information for your team.

Which blocked tear duct test answers which question: a summary table

No single blocked tear duct test does everything, which is why examiners layer them. The table below sets out what each one asks and where it falls short, so a report or a proposed scan can be read in context.

Test	What enters the eye or duct	Main question it answers	What it cannot tell you
Fluorescein dye disappearance	A dye drop on the surface only	Is drainage delayed under normal blinking?	The level of the block
Irrigation (syringing)	Saline through a blunt cannula	Is the passage open, and if not, is the block above or below the sac?	Whether an open duct actually pumps well
Probing with hard or soft stop	A fine probe along the canaliculus	Are the canaliculi open to the sac?	Anything about the duct below the sac
Jones I and II	Dye, then saline	Anatomical block or functional (pump) failure?	Fine structural detail
Dacryocystography (DCG)	Contrast through a cannula, then X-ray or CT	Exact shape, size and level of the block; stones or pouches	Function under a natural blink
Dacryoscintigraphy	A tracer drop on the surface	How fast tears travel physiologically	Precise anatomy
CT or MRI	Nothing in the duct (unless combined with DCG)	Bone, sinuses and soft tissue around the duct	Whether the duct is functionally patent
Nasal endoscopy	A telescope in the nostril	Is the exit into the nose clear?	The state of the upper system

Read across a row and the pattern is obvious: surface tests show function, injected tests show anatomy, and imaging shows the surroundings. A thorough workup usually pairs one from the first group with one from the second, and adds the third only when surgery or an unusual finding is in view. If your report contains results from only one column, it is reasonable to ask whether the other has been considered.

What people often get wrong about tear duct tests

A few misunderstandings come up in almost every consultation, and correcting them saves disappointment later.

“The flush fixed it.” Irrigation is a diagnostic test. It sometimes shifts a mucus plug and the eye dries up for a while, but a scarred or narrowed duct has not been widened by a syringe of saline. When watering returns, the underlying level of block is the same as it was.

“My eye waters because it makes too many tears.” Occasionally true, usually not. The NHS notes that watering is commonly caused by irritation or dryness triggering reflex tears, or by poor drainage. The dye test and irrigation exist precisely to tell those apart, and treating an assumed overproduction can miss a real block.

“The test was normal, so nothing is wrong.” A duct that is open to irrigation can still drain poorly under the gentle force of a blink. That is the functional block the Jones tests and dacryoscintigraphy are designed to catch. Normal syringing narrows the possibilities; it does not close the case.

“Everyone needs a scan.” Imaging is added when the level is unclear, when surgery is planned, or when something unusual is suspected. Mayo Clinic’s account of diagnosis describes irrigation and dye testing as the core, with imaging used selectively.

“A baby’s blocked duct needs testing straight away.” Most infant blocks open during the first year without any procedure, according to Mayo Clinic, and awake irrigation is rarely appropriate. Observation is an active plan, not neglect.

“It will hurt.” With numbing drops, the flush is more strange than painful: pressure at the inner corner, then salt at the back of the throat. People who dread it often say afterward that the anticipation was the worst part.

The thread running through all of these is the same. The test’s value lies in the level, not in the flush itself, and a good examiner will tell you the level in plain words before you leave.

Questions to ask your care team before and after the test

Bring these on paper. Consultations move quickly, and the answers shape what happens next.

Before the test

• Which tests do you plan to do today, and will any involve an instrument entering the duct?
• Should I stop wearing contact lenses or eye makeup beforehand?
• Do you want me to hold off on any eye drops I currently use so they do not affect the dye test?
• If I have had a recent infection over the tear sac, is now the right time to irrigate?

After the test

• At what level is the block: punctum, canaliculus, sac or nasolacrimal duct?
• Is it complete or partial, and did the duct seem open but slow, which would point to a pump problem?
• Did fluid come back cloudy or with mucus, and what does that suggest about the sac?
• Do you recommend imaging, and if so, which specific question is the scan meant to answer?
• Has the nasal side been examined, or should it be?
• What are the options at this level, including doing nothing for now, and what are the risks and trade-offs of each?
• How will we know if watchful waiting is not working?
• What signs should prompt me to contact you before the next appointment?

For parents

• What features would make you want to see my child sooner than the usual review?
• If a probing procedure is eventually suggested, how is that decision made and what does the day involve?

Notice that none of these questions asks the team to promise an outcome. Drainage surgery, when it is offered, has variable results depending on the level and cause, and a careful clinician will describe those in terms of likelihood and uncertainty rather than guarantees. The most useful answer you can leave with is a precise description of where the tears stop, because that is the one fact every later decision rests on.

When to call your doctor

A watering eye is rarely urgent on its own. Certain accompanying signs are different, because they point to infection spreading from a stagnant sac, to injury, or, uncommonly, to a growth in the drainage pathway. Contact your eye specialist or seek same-day care if you notice any of the following, whether or not you have already had a blocked tear duct test.

• Redness, warmth, swelling or tenderness over the inner corner of the eye and side of the nose, especially if it developed over a day or two. This is the typical picture of dacryocystitis, an infection of the lacrimal sac, which Mayo Clinic lists among the complications of an untreated block.
• Fever or feeling generally unwell alongside that swelling.
• Swelling that spreads onto the eyelids or cheek, or makes it hard to open the eye.
• Any change in vision, double vision, or pain when moving the eye. These suggest inflammation reaching deeper tissues and need urgent assessment.
• Blood-stained tears or bloody discharge from the punctum.
• A firm lump beside the nose that is not tender and is slowly enlarging.
• In a baby: a bluish swelling below the inner corner present from birth, any redness or heat over it, a red eyeball, light sensitivity, or a cloudy cornea. Those last three are not features of a simple blocked duct and need prompt review.

After irrigation or a dacryocystography scan, mild soreness and a stuffy nose are expected. Increasing pain, spreading redness, pus, or a fever in the following days are not, and should be reported.

Between appointments, keep a simple note of which days the eye waters, whether discharge appears, and anything that seems to trigger it. That record is often more informative than any single test. Every decision about further testing, watchful waiting or a procedure belongs with the team who has examined you, and this article is meant to help you understand their reasoning, not replace it.

Frequently asked questions

Does a blocked tear duct test hurt?

For most people it is uncomfortable rather than painful. Numbing drops are placed first, so dilating the punctum and passing the blunt cannula feel like firm pressure at the inner corner of the eye. Saline reaching the nose produces a salty taste and a brief urge to swallow. The dye disappearance test involves only a drop and a blue light. Mild soreness afterward usually settles the same day.

What does it mean if I taste salt during the tear duct flushing procedure?

It means the saline traveled the full length of the drainage system and reached the back of your nose and throat, so the passage is open to irrigation. That does not always rule out a drainage problem, because a duct can be anatomically open yet pump poorly during normal blinking. If watering persists despite a patent flush, your specialist may add a functional test such as the Jones tests or dacryoscintigraphy.

What is a dacryocystography scan and why would I need one?

A dacryocystography scan is an X-ray or CT taken after a small volume of contrast liquid is injected into the tear duct through a fine cannula. It outlines the duct so the exact level, shape and length of a block can be seen, along with any stones or pouches in the lacrimal sac. It is usually reserved for unclear cases or for planning before a surgical bypass rather than used routinely.

How is nasolacrimal duct obstruction diagnosis different in babies?

Infants are usually diagnosed clinically rather than with irrigation. The examiner looks for a wet eye with sticky discharge in a calm, white eyeball, presses gently over the sac to see whether mucus appears, and may use the fluorescein dye disappearance test. Awake irrigation and imaging are generally avoided. Mayo Clinic notes most infant blocks open during the first year of life, so observation with gentle massage is common.

Can the fluorescein dye disappearance test alone diagnose a blocked tear duct?

No. Slow clearance of dye shows that drainage is delayed somewhere along the pathway, but it cannot say whether the problem is at the punctum, canaliculus, sac or nasolacrimal duct, and it cannot separate a physical block from a weak pump. It is a useful, comfortable first step that tells the examiner whether further testing, usually irrigation, is worth doing.

What is the difference between a hard stop and a soft stop?

These describe what the examiner feels when a fine probe is passed along the canaliculus. A hard stop means the probe has reached the bony wall of the lacrimal sac, so the canaliculi are open and any block lies lower down. A soft stop is a spongy resistance before that point, meaning the probe is pressing against a closed or scarred canaliculus in the upper part of the system.

Will flushing the tear duct fix the blockage?

Irrigation is a diagnostic test rather than a treatment. Occasionally it dislodges a soft plug of mucus and the eye dries up for a while, but a narrowed or scarred duct has not been widened. When the watering returns, the level of obstruction is unchanged. Any decision about a procedure to open or bypass the duct is made separately by your specialist once the level is confirmed.

Why would my eye specialist look inside my nose?

Tears exit inside the nose beneath the inferior turbinate, so a problem at that exit can cause watering that looks like an eye problem. Nasal endoscopy uses a slim telescope after numbing spray to check for a deviated septum, polyps, scar tissue or swelling crowding the opening. It is also used to confirm in real time that flushed saline or dye arrives in the nose.

What is a functional tear duct blockage?

A functional block means the drainage passages are anatomically open but tears still do not clear, usually because the blink-driven pump is weak. Loose lower eyelids, facial muscle weakness or a punctum that has rolled away from the tear film are typical causes. Irrigation often appears normal in these cases; the Jones tests and dacryoscintigraphy, which follow dye under natural blinking, are the studies most likely to reveal it.

What should I avoid after tear duct irrigation or imaging?

Most examiners advise against forceful nose-blowing and eye makeup for the rest of the day, and contact lens wearers are usually asked to leave lenses out until any fluorescein has cleared, since soft lenses can absorb the dye. Mild soreness and a stuffy nose are expected. Increasing pain, spreading redness, pus or fever in the following days are not expected and should be reported to your care team.

References

• NHS: Watering eyes
• MedlinePlus Medical Encyclopedia: Blocked tear duct
• NIH National Library of Medicine, StatPearls: Nasolacrimal Duct Obstruction

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.