Does every sinus infection cause tearing?

No. Only about 10–15 % of acute sinus infections cause enough swelling to obstruct the duct.

How can I tell if the watering is from allergies or infection?

Allergy-related tearing is usually clear, itchier, and comes with sneezing; infection-related tearing may be paired with thick nasal discharge and facial pain.

Can over-the-counter decongestants help unblock the duct?

Short-term (less than three days) oral or topical decongestants may reduce swelling, but overuse can worsen obstruction.

Is it safe to massage my infant’s tear duct if they also have a cold?

Yes, gentle massage is part of standard care, but see a pediatrician if there is fever, redness, or the blockage lasts more than two weeks.

What if I wear contact lenses?

Switch to glasses until tearing and any infection have fully resolved to avoid trapping bacteria against the eye.

Will antihistamine eye drops fix a sinus-related blockage?

They may ease itching but do not address duct obstruction; treat the sinus swelling for best results.

How long after sinus surgery will tearing improve?

Most patients notice relief within two weeks, but scar-related obstruction can take several months to settle.

Can smoking worsen tear duct blockage?

Yes. Tobacco smoke irritates nasal mucosa, increasing swelling and mucus production, raising blockage risk by up to 30 %.

Are warm compresses safe after cataract surgery?

Wait until your eye surgeon clears you—usually after the first postoperative week—before applying heat near the eye.

Can a sinus infection really block your tear ducts?

How does a sinus infection physically block the tear duct?

A sinus infection inflames the mucous lining of both the sinuses and the nasolacrimal duct, which share the same drainage path into the nasal cavity. “When the sinus lining swells even 2–3 mm, the duct’s 1–2 mm opening can seal shut,” explains Sina Hartung, MMSC-BMI.

Shared anatomy creates a bottleneckThe nasolacrimal duct empties beneath the inferior turbinate, metres away from the maxillary sinus ostium; inflammation in one space quickly spreads to the other.
Mucus can plug the narrow duct openingThick purulent mucus produced during bacterial sinusitis has a viscosity up to 10 × normal nasal secretions, easily forming a cap over the duct orifice.
Swelling peaks between days 2 and 5 of infectionCT studies show mucosal thickness doubles within 48 hours of acute sinusitis onset, the same window when patients report sudden watery eyes.
Chronic sinusitis scars the duct liningLong-standing inflammation can cause fibrosis, narrowing the duct diameter from a normal 0.3 cm to as little as 0.1 cm.
Most blockages resolve in 7–10 daysIn prospective series, 80 % of tear duct obstructions related to uncomplicated sinusitis cleared after the infection was treated.
Chronic sinusitis is a leading adult cause of nasolacrimal duct obstructionThe American Academy of Ophthalmology lists long-standing sinus infections among the most common acquired causes because repetitive inflammation promotes scar tissue that narrows the duct. (AAO)
Sinus-related blockage can escalate to dacryocystitisAll About Vision warns that when swollen sinus tissue prevents tears from draining, stagnant fluid in the lacrimal sac becomes a breeding ground for bacteria, resulting in painful dacryocystitis. (AAV)

Which sinus-related tear duct symptoms mean you should see a doctor today?

While mild watering is common, certain signs point to more serious obstruction or infection of the duct itself. “Any spreading redness around the eye socket can become cellulitis within hours,” warns the team at Eureka Health.

Fever above 38.5 °C with eye painSuggests dacryocystitis or orbital cellulitis, both require urgent antibiotics.
Bulging or redness of the inner eyelidIndicates the lacrimal sac is distended; 30 % progress to abscess if untreated.
Pus draining from the tear punctumA yellow or green discharge signals bacterial infection inside the duct.
Vision changes or double visionCould mean orbital involvement; emergency imaging is needed.
Severe swelling that worsens despite 48 h of treatmentMay reflect resistant organisms or underlying anatomical blockage.
Blood-tinged tears warrant same-day assessmentBausch + Lomb lists blood-stained tears among urgent warning signs of a blocked or infected tear duct, as they can signal active bleeding or severe inflammation that may spread rapidly. (B+L)
Repeat eye infections point to persistent duct obstructionThe American Academy of Ophthalmology advises prompt evaluation when eye infections keep returning, noting that chronic nasolacrimal blockage allows bacteria to collect and re-infect surrounding tissue. (AAO)

What everyday factors—besides sinus infection—can plug tear ducts?

Not every watery eye during cold season is caused by sinusitis. Sina Hartung, MMSC-BMI, notes, “Ageing alone halves tear duct diameter by the seventh decade.”

Age-related narrowingDegenerative tissue changes cause up to 70 % of new adult blockages.
Seasonal allergiesHistamine-driven swelling can mimic infection but often clears with antihistamines.
Nasal decongestant overuseRebound swelling (rhinitis medicamentosa) after >3 days of sprays compresses the duct outlet.
Trauma or nasal surgeryPost-operative scar tissue can obstruct the valve of Hasner, the duct’s exit.
Auto-immune disordersSarcoidosis or granulomatosis with polyangiitis inflame mucosal linings throughout the airway, including the duct.
Glaucoma eye-drops can chemically scar drainage channelsWebMD notes that long-term use of certain glaucoma medications may narrow or block the nasolacrimal duct, producing chronic watery eyes even without infection. (WebMD)
Cancer therapies such as radioactive iodine may shut the ductHealthline reports that chemotherapy or radioactive iodine treatment can damage duct lining tissue, preventing tears from reaching the nose and causing overflow. (Healthline)

How can you relieve a sinus-related tear duct blockage at home?

Most minor blockages clear without procedures if swelling and infection are tamed early. The team at Eureka Health advises, “Focus on thinning mucus and keeping the duct opening warm and patent.”

Warm compresses 4–6 times dailyApply a clean, microwaved moist cloth (not hotter than 43 °C) over the inner eye corner for 5 minutes to soften mucus plugs.
Nasal saline irrigationRinsing with 240 mL isotonic saline twice daily reduces sinus mucus load by 60 % in clinical trials.
Hydration of 2–3 L fluids per dayThinner secretions drain more easily; aim for pale-yellow urine as a guide.
Humidified air while sleepingA room humidity of 40–50 % prevents overnight crusting at the duct opening.
Gentle lacrimal sac massagePress index finger below the inner canthus and roll downward 5–10 times; small studies show 30 % faster resolution.
Keep eyelids clean and practice strict hand hygieneHome-care guidelines advise washing hands before and after touching the eye and gently wiping away crust or discharge with a warm, wet cloth to curb bacterial growth and avoid worsening the blockage. (Drugs.com)

Which tests and treatments might your clinician order for persistent blockage?

If tearing lasts beyond two weeks or red-flag signs appear, evaluation moves beyond simple sinus care. “Fluorescein dye disappearance in 5 minutes or less virtually rules out significant obstruction,” reminds Sina Hartung, MMSC-BMI.

Nasal endoscopyAllows ENT to visualize mucosal edema and confirm the valve of Hasner is open.
Fluorescein dye testDye placed in the eye should drain in <5 min; lingering dye suggests blockage.
CT scan of sinuses and orbitsDetects bony narrowing, masses, or complex sinus disease before surgery.
Topical or systemic antibioticsCulture-guided therapy reduces dacryocystitis recurrence from 40 % to 10 %.
Balloon dacryoplasty or DCR surgeryFor chronic obstruction, success rates exceed 90 % in relieving tearing.
In-office irrigation and probing can diagnose and clear soft obstructionsOphthalmologists may flush saline through the puncta and use a probe; free flow confirms patency, while resistance pinpoints and sometimes removes the blockage in the same sitting. (McDevittEyeCare)
Silicone stenting maintains duct patency when dilation alone is insufficientA tiny tube is threaded through the nasolacrimal system to keep it open; the stent is removed after healing, offering a minimally invasive alternative before formal surgery. (Higgins)