Pet Factsheets

Tear duct flushing

A corneal ulcer
©Richard Saunders

If your rabbit looks like they are crying it is likely a tear duct blockage, stopping normal drainage, and causing the tears to run out of the eye and down the cheek. Tear duct problems are very common in rabbits and are often associated with dental disease.

Why does my rabbit have tears and tear ducts?

Tears are essential to lubricate the eyes; without them the eyes would quickly dry out causing serious pain and damage to the surface. In the normal rabbit eye tears are produced, they lubricate and protect the eye and then drain into the nasolacrimal (tear) duct which travels through the lacrimal and maxillary bones to the nostrils from the eye.

Why do tears sometimes overflow onto my rabbit's face?

Unfortunately, in some rabbits the tear ducts can become blocked. This is common in rabbits with dental problems since the upper tooth roots overgrow and impinge on the tear ducts, causing them to kink and block. This means the tears cannot take the normal route down the duct and out of the nostril, so overflow out of the eye and down the cheek.

Breeds that have shortened faces, such as lops, and the Netherland Dwarf are particularly prone to the problem. Diet is crucial in preventing and treating dental disease, so it is important to ensure your rabbit is fed a good quality diet, made up of at least 80% hay and grass, 15% fresh greens and 5% pellets. Muesli style diets must not be fed, and care should be taken to avoid the overfeeding of pellets, which will lessen the rabbits hay consumption.

How will my vet diagnose the problem?

Diagnosis is generally straightforward. To diagnose a nasolacrimal duct obstruction the rabbit can remain conscious (unless they are really troublesome, and handling causes extreme stress). A drop of fluorescein stain is applied to the eye. This is non-invasive and painless. The stain appears green when it comes into contact with the eye. If the duct is clear it will flow down from the eye, through the tear duct and appear as a green stain out of the corresponding nostril. Both eyes should be checked. If there is a blockage present, no stain will appear on that side of the nostril. The stain will also show if there are any corneal ulcers, like the picture above.

How will my vet treat my rabbit?

Your vet will attempt to flush the tear duct, which can help to open it back up again. Sometimes there can be infection present. If this is the case, the overflowing tears can be milky in appearance.

Your vet will place a small cannula into the nasolacrimal (tear) duct opening on the inside of the eye. This is done under local anaesthetic so is not painful and your rabbit shouldn’t need sedation or an anaesthetic unless they are nervous about being handled. Your vet will attempt to flush from the eye to the nostril using sterile saline and possibly also antibiotics if an infection is present. Sometimes it can take several attempts before the duct will flush, and there are times when the blockage is too great, and the duct cannot be flushed at all due to the blockage or scar tissue.

Eye drops are rarely effective as they cannot flow into the blocked duct but can be helpful to reduce irritation around the area.

If dental disease is diagnosed as the underlying cause, dental treatment will be necessary. This will require x-rays to assess the tooth roots to see if extraction of any of the teeth is required. The diet must also be looked at to ensure it is correct.

Your rabbit may require repeated flushing’s at regular intervals, and between flushing’s it is important that the fur around the eye is kept clean and dry, so the skin does not become infected and sore.

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