Patient Basics: Tear Duct Infection (Dacryocystitis)

Dacryocystitis, often called a tear duct infection, is an infection of the tear sac, a small pouch that sits beside the nose, just inside the eye’s inner corner. It usually starts when the tear drainage duct is blocked, so tears pool and germs grow. The area swells, turns red and hurts. It needs antibiotics from a doctor, and a lasting blockage may need a small operation.

Key points

• The main sign is a tender, red lump on the side of the nose, right next to the eye.
• A blocked tear duct is almost always the cause. In adults, the duct often narrows with age.
• Antibiotic pills and warm compresses treat most infections.
• If the blockage stays, surgery can make a new path for tears to drain into the nose.
• Swollen eyelids, pain when moving the eye or changes in vision need emergency care.

How tears drain

Glands above each eye make tears all day. Every time you blink, tears wash across the eye and flow into two tiny openings at the inner corner of the eyelids. From there, they pass into the tear sac and down a narrow tube (the nasolacrimal duct) into the nose. That’s why your nose runs when you cry.

When the duct is blocked, tears can’t drain. They back up in the sac, and bacteria that live on the skin and in the nose can grow there.

What causes dacryocystitis

• Narrowing with age. In adults, the duct slowly narrows over the years. This is most common in women over 40.
• Blocked duct at birth. Many babies are born with a duct that hasn’t fully opened. Most open on their own within the first year. A few become infected.
• Nose and sinus problems. Long-term sinus inflammation, nasal polyps or a deviated septum can press on the duct.
• Injury or surgery. A broken nose or bones around the eye, or past nose or sinus surgery, can scar the duct.
• Less common causes. These include inflammatory diseases and, rarely, a growth in the sac or nose.

Symptoms of a tear duct infection

A sudden (acute) infection can cause:

• A painful, red, warm swelling in the inner corner of the eye, beside the nose
• Pus or thick mucus seeping out near the nose side of the eye, especially when you press on the swelling
• A watery eye, with tears running down the cheek
• Crusting of the eyelashes, often worse in the morning
• Fever in some people

A long-term (chronic) infection is milder. The main signs are a constantly watery eye, mucus in the inner corner and repeated pink eye on the same side.

In newborns, a blocked duct usually shows up as a watery eye or sticky discharge in the first weeks of life. A bluish or red swelling beside the nose in a newborn needs to be seen by a doctor quickly.

How it’s diagnosed

A doctor can usually tell from the location of the swelling and the discharge. They may press gently on the sac to see whether pus comes out, and may swab it for a lab test. An eye doctor (ophthalmologist) may flush the duct with salt water after the infection settles to see if it is blocked. If the infection seems to be spreading, or doctors suspect a growth, you may have a CT scan.

Dacryocystitis treatment

Treating the infection

• Antibiotic pills are the main treatment. Take the whole course, even after the swelling goes down.
• Warm compresses. Hold a clean, warm, damp cloth over the area for several minutes, a few times a day. This eases pain and helps the sac drain.
• Pain relief with acetaminophen or ibuprofen.
• Antibiotics through a vein in the hospital are needed if the infection spreads to the eyelids or the tissue around the eye, and for young babies.
• Draining the sac. If a pocket of pus forms, a doctor may open it to let the pus out.

Treating the blockage

If the duct stays blocked, the infection is likely to come back. An operation called dacryocystorhinostomy (DCR) makes a new opening from the tear sac straight into the nose, bypassing the blocked duct. It can be done through a small cut beside the nose or from inside the nose with a thin camera (endoscope), with no cut on the skin. A thin silicone tube is often left in place for a few months while the new opening heals. Surgery is done after the infection has cleared, and it works for most people.

Babies

Most blocked ducts in babies open on their own. A doctor may show you how to massage the area gently, pressing downward beside the nose, to help it open. If the duct is still blocked around the first birthday, an eye doctor can open it with a thin probe, usually during brief anesthesia. A baby with a red, swollen tear sac needs prompt care, often with IV antibiotics.

Recovery

With antibiotics, redness and pain usually improve within a few days. A watery eye may last until the blockage is treated. After DCR surgery, most people go home the same day. Mild bruising, a stuffy nose and a little bleeding from the nose for a few days are common.

When to see a doctor

• A red, painful swelling between your eye and nose
• Pus or mucus that keeps collecting near the eye
• A watery eye that lasts for weeks
• Any swelling or discharge near the eye in a newborn

Get emergency care if you have

• Swollen, red eyelids that make it hard to open the eye
• Pain when you move your eye, or a bulging eye
• Blurred or double vision
• High fever, or feeling very unwell

These can mean the infection has spread to the tissue around the eye (orbital cellulitis), which can harm vision.

Common questions about dacryocystitis

Why does the corner of my eye near my nose hurt?

A tender, red lump right beside the nose is often an infected tear sac. Pain there can also come from a stye or another eyelid bump, pink eye, a sinus infection or a scratch on the eye. See a doctor if the area is swollen or leaking pus, or if your vision changes.

What is a white spot in the corner of my eye by the tear duct?

It is often dried mucus, or a small point of pus if the area is infected. A painless white or yellow bump on the white of the eye may be a pinguecula (a harmless thickening), and a tiny white bump on the skin may be a milium (a small cyst). Have it checked if it hurts or grows.

Can I treat an infected tear duct at home?

Warm compresses and pain relievers help, but an infected tear duct needs antibiotics from a doctor. Don’t squeeze the swelling or try to drain it yourself, because that can push the infection deeper. Gentle massage beside the nose is mainly used for babies with a blocked duct, and only as a doctor shows you.

Questions to ask your doctor

• Is my tear duct blocked, and what caused it?
• How long should I take the antibiotics?
• Do I need to see an eye specialist?
• Is surgery a good idea for me, and which kind?
• What signs mean the infection is spreading?

Learn more

• Blocked tear duct (MedlinePlus, U.S. National Library of Medicine)
• Watering eyes (NHS)

This guide is general information and doesn’t replace advice from your own doctor. Last updated October 2026.