nih-gov/medlineplus.gov/ency/article/001016.htm
2025-02-26 13:17:41 -05:00

294 lines
No EOL
30 KiB
HTML
Raw Blame History

This file contains invisible Unicode characters

This file contains invisible Unicode characters that are indistinguishable to humans but may be processed differently by a computer. If you think that this is intentional, you can safely ignore this warning. Use the Escape button to reveal them.

This file contains Unicode characters that might be confused with other characters. If you think that this is intentional, you can safely ignore this warning. Use the Escape button to reveal them.

<!DOCTYPE html>
<html lang="en" id="article" class="nojs us" data-root="//medlineplus.gov" itemid="https://medlineplus.gov/ency/article/001016.htm" itemtype="http://schema.org/MedicalWebPage" itemscope="">
<head>
<meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1"/>
<meta http-equiv="window-target" content="_top"/>
<meta http-equiv="Content-Type" content="text/html; charset=UTF-8"/>
<meta charset="utf-8"/>
<meta property="fb:app_id" content="1042245625821448"/>
<meta name="expires" content="Wed, 05 02 2025"/>
<meta name="ac-dictionary" content="medlineplus-ac-dictionary"/>
<link rel="shortcut icon" href="https://medlineplus.gov/images/favicon.ico" type="image/x-icon"/>
<link rel="apple-touch-icon" href="//medlineplus.gov/images/touch-icon.png"/>
<meta name="viewport" content="width=device-width, initial-scale=1"/>
<link rel="stylesheet" href="https://medlineplus.gov/css/common_new.css?04272023"/>
<!--[if IE 8]> <link rel="stylesheet" href="https://medlineplus.gov/css/ie8/common.css"><![endif]-->
<link rel="stylesheet" href="https://medlineplus.gov/uswds/css/uswds_styles.css"/>
<link rel="stylesheet" href="https://medlineplus.gov/css/ency/ency2.css?07162024"/>
<script type="text/javascript">document.querySelector("html").className = document.querySelector("html").className.replace(/nojs[\s]*/g, '');</script>
<script src="https://medlineplus.gov/uswds/js/uswds-init.min.js" type="text/javascript">
</script>
<script>(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&amp;l='+l:'';j.async=true;j.src='//www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-MMVM77');</script>
<link rel="canonical" href="https://medlineplus.gov/ency/article/001016.htm" itemprop="url"/>
<link rel="alternative" hreflang="es" href="https://medlineplus.gov/spanish/ency/article/001016.htm"/>
<link rel="alternative" hreflang="en" href="https://medlineplus.gov/ency/article/001016.htm"/><meta property="og:title" content="Blocked tear duct: MedlinePlus Medical Encyclopedia"/><meta property="og:url" content="https://medlineplus.gov/ency/article/001016.htm"/><meta property="twitter:title" content="Blocked tear duct: MedlinePlus Medical Encyclopedia"/><meta name="twitter:card" content="summary_large_image"/><meta name="description" content="A blocked tear duct is a partial or complete blockage in the pathway that carries tears from the surface of the eye into the nose."/><meta itemprop="description" name="description" content="A blocked tear duct is a partial or complete blockage in the pathway that carries tears from the surface of the eye into the nose."/><meta property="og:description" content="A blocked tear duct is a partial or complete blockage in the pathway that carries tears from the surface of the eye into the nose."/><meta property="twitter:description" content="A blocked tear duct is a partial or complete blockage in the pathway that carries tears from the surface of the eye into the nose."/><meta property="og:image" content="https://medlineplus.gov/images/share_ency_1.jpg"/><meta property="og:image" content="https://medlineplus.gov/images/share_ency_2.jpg"/><meta property="og:image" content="https://medlineplus.gov/images/share_ency_3.jpg"/><meta property="twitter:image" content="https://medlineplus.gov/images/share_ency_1.jpg"/>
<title>Blocked tear duct: MedlinePlus Medical Encyclopedia</title>
</head>
<body><link href="http://schema.org/Patient" itemprop="audience"/>
<!-- Google Tag Manager -->
<noscript><iframe title="googletagmanager" src="//www.googletagmanager.com/ns.html?id=GTM-MMVM77" height="0" width="0" style="display:none;visibility:hidden">
</iframe>
</noscript>
<!-- End Google Tag Manager -->
<a name="top" id="top">
</a>
<a class="hide-offscreen" href="#start">Skip navigation</a>
<section class="usa-banner" aria-label="Official website of the United States government">
<div class="usa-accordion">
<header class="usa-banner__header">
<div class="usa-banner__inner">
<div class="grid-col-auto">
<img aria-hidden="true" class="usa-banner__header-flag" src="https://medlineplus.gov/uswds/img/us_flag_small.png" alt=""/>
</div>
<div class="grid-col-fill tablet:grid-col-auto" aria-hidden="true">
<p class="usa-banner__header-text">
An official website of the United States government
</p>
<p class="usa-banner__header-action">Heres how you know</p>
</div>
<button type="button" class="usa-accordion__button usa-banner__button" aria-expanded="false" aria-controls="gov-banner-default-default">
<span class="usa-banner__button-text">Heres how you know</span>
</button>
</div>
</header>
<div class="usa-banner__content usa-accordion__content" id="gov-banner-default-default">
<div class="grid-row grid-gap-lg">
<div class="usa-banner__guidance tablet:grid-col-6">
<img class="usa-banner__icon usa-media-block__img" src="https://medlineplus.gov/uswds/img/icon-dot-gov.svg" role="img" alt="" aria-hidden="true"/>
<div class="usa-media-block__body">
<p>
<strong>Official websites use .gov</strong><br/>A
<strong>.gov</strong> website belongs to an official government
organization in the United States.
</p>
</div>
</div>
<div class="usa-banner__guidance tablet:grid-col-6">
<img class="usa-banner__icon usa-media-block__img" src="https://medlineplus.gov/uswds/img/icon-https.svg" role="img" alt="" aria-hidden="true"/>
<div class="usa-media-block__body">
<p>
<strong>Secure .gov websites use HTTPS</strong><br/>A
<strong>lock</strong> (
<span class="icon-lock"><svg xmlns="http://www.w3.org/2000/svg" width="52" height="64" viewBox="0 0 52 64" class="usa-banner__lock-image" role="img" aria-labelledby="banner-lock-description-default" focusable="false">
<title id="banner-lock-title-default">Lock</title>
<desc id="banner-lock-description-default">Locked padlock icon</desc>
<path fill="#000000" fill-rule="evenodd" d="M26 0c10.493 0 19 8.507 19 19v9h3a4 4 0 0 1 4 4v28a4 4 0 0 1-4 4H4a4 4 0 0 1-4-4V32a4 4 0 0 1 4-4h3v-9C7 8.507 15.507 0 26 0zm0 8c-5.979 0-10.843 4.77-10.996 10.712L15 19v9h22v-9c0-6.075-4.925-11-11-11z">
</path>
</svg> </span>) or <strong>https://</strong> means youve safely connected to
the .gov website. Share sensitive information only on official,
secure websites.
</p>
</div>
</div>
</div>
</div>
</div>
</section>
<div id="mplus-wrap">
<header>
<div id="mplus-header">
<!-- Orgs
================================================== -->
<div id="mplus-orgs">
<a title="National Institutes of Health" target="_blank" class="nih-org" href="//www.nih.gov/">
<img alt="National Institutes of Health" src="https://medlineplus.gov/images/nihlogo.png" class="nihlogo"/>
</a><a target="_blank" href="https://www.nlm.nih.gov/"> National Library of Medicine </a>
</div>
<!-- Logo
================================================== -->
<div id="mplus-logo" class="years-25">
<a href="https://medlineplus.gov">
<img src="https://medlineplus.gov/images/m_logo_25.png" title="MedlinePlus Trusted Health Information for You" alt="MedlinePlus Trusted Health Information for You"/>
</a>
</div>
<!-- Nav Menu
================================================== -->
<div id="mplus-nav">
<div class="sm-live-area hide-offscreen" aria-live="polite">The navigation menu has been collapsed.</div>
<!-- Menu Button-->
<button type="submit" aria-controls="mplus-menu-list" role="button" title="Menu" class="navmenu-btn" id="sm-menu-btn" aria-pressed="false" tabindex="0">Menu<span class="icon icon-nav-menu">
</span></button><ul class="nav-list" id="mplus-menu-list">
<li><a href="https://medlineplus.gov/healthtopics.html">Health Topics</a></li>
<li><a href="https://medlineplus.gov/druginformation.html">Drugs &amp; Supplements</a></li>
<li><a href="https://medlineplus.gov/genetics/">Genetics</a></li>
<li><a href="https://medlineplus.gov/lab-tests/">Medical Tests</a></li>
<li><a href="https://medlineplus.gov/encyclopedia.html">Medical Encyclopedia</a></li>
<li><a href="https://medlineplus.gov/about/">About MedlinePlus</a></li>
</ul><button type="submit" aria-controls="mplus-search" role="button" title="Search" class="navmenu-btn" id="sm-search-btn" aria-pressed="false" tabindex="0"><span class="hide-offscreen">Show </span>Search<span class="icon icon-nav-search">
</span></button>
<div class="top-1">
<!-- Search
================================================== -->
<form target="_self" title="Search MedlinePlus" action="//vsearch.nlm.nih.gov/vivisimo/cgi-bin/query-meta" method="get" id="mplus-search">
<input type="hidden" value="medlineplus" name="v:project"/>
<input type="hidden" value="medlineplus-bundle" name="v:sources"/>
<div class="form-box text-combo">
<div class="form-area"><label for="searchtext_primary" class="hide-offscreen">Search MedlinePlus</label>
<span role="status" aria-live="polite" class="ui-helper-hidden-accessible">
</span><input type="text" aria-haspopup="true" aria-autocomplete="list" role="textbox" autocomplete="off" name="query" size="40" maxlength="400" title="Site Search input" alt="Site Search input" placeholder="Search MedlinePlus" class="form-text ui-autocomplete-input" id="searchtext_primary"/>
</div>
<div class="button-area">
<button type="submit" alt="Search MedlinePlus" title="Search MedlinePlus" class="form-btn">GO</button>
</div>
</div>
</form>
<!-- Secondary Nav
================================================== -->
<div class="secondarynav">
<ul class="nav-list">
<li><a href="https://medlineplus.gov/about/"><span>About MedlinePlus</span></a></li>
<li><a href="https://medlineplus.gov/whatsnew/"><span>What's New</span></a></li>
<li><a href="https://medlineplus.gov/sitemap.html"><span>Site Map</span></a></li>
<li><a target="_blank" href="https://support.nlm.nih.gov/knowledgebase/category/?id=CAT-01231&amp;category=medlineplus&amp;from=//medlineplus.gov/ency/article/001016.htm"><span>Customer Support</span></a></li>
</ul>
</div>
</div>
<!-- Nav Bar
================================================== -->
<div id="mplus-nav-bar">
<ul class="nav-list">
<li><a href="https://medlineplus.gov/healthtopics.html">Health Topics</a></li><li><a href="https://medlineplus.gov/druginformation.html">Drugs &amp; Supplements</a></li><li><a href="https://medlineplus.gov/genetics/">Genetics</a></li><li><a href="https://medlineplus.gov/lab-tests/">Medical Tests</a></li><li><a href="https://medlineplus.gov/encyclopedia.html">Medical Encyclopedia</a></li>
</ul>
</div>
<a title="Español" id="mplus-lang-toggle" href="../../spanish/ency/article/001016.htm">Español</a>
</div>
</div>
</header>
<!-- Content
================================================== -->
<div id="mplus-content">
<!-- Breadrcumbs -->
<div id="breadcrumbs"><div itemtype="http://schema.org/BreadcrumbList" itemscope="" itemprop="breadcrumb"><span class="hide-offscreen">You Are Here:</span>
<div itemscope itemprop="itemListElement" itemtype="http://schema.org/ListItem">
<a href="https://medlineplus.gov" itemprop="item"><span itemprop="name">Home</span></a>
&rarr;
<meta itemprop="position" content="1"/>
</div>
<div itemscope itemprop="itemListElement" itemtype="http://schema.org/ListItem">
<a href="https://medlineplus.gov/encyclopedia.html" itemprop="item"><span itemprop="name">Medical Encyclopedia</span></a>
&rarr;
<meta itemprop="position" content="2"/>
</div>
</div><div><span>Blocked tear duct</span></div></div>
<span class="page-url print-only">URL of this page: //medlineplus.gov/ency/article/001016.htm
</span>
<!-- Article -->
<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
</a><h1 class="with-also" itemprop="name">Blocked tear duct</h1>
</div><div class="page-actions">
</div>
<noscript>
<span class="js-disabled-message">To use the sharing features on this page, please enable JavaScript.</span>
</noscript></div><div class="main"><div id="ency_summary"><p>A blocked tear duct is a partial or complete blockage in the pathway that carries tears from the surface of the eye into the nose.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
</div></div><div class="section-body" id="section-1"><p>Tears are constantly being made to help protect the surface of your eye. They drain into a very small opening (punctum) in the corner of your eye, near your nose. This opening is the entrance to the nasolacrimal duct. If this duct is blocked, the tears will build up and overflow onto the cheek. This occurs even when you are not crying.</p><p>In children, the duct may not be completely developed at birth. It may be closed or covered by a thin film, which causes a partial blockage. </p><p>In adults, the duct can be damaged by an infection, injury, or a tumor.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
</div></div><div class="section-body" id="section-2"><p>The main symptom is <a test="test" href="./003036.htm">increased tearing</a> (epiphora), which causes tears to overflow onto the face or cheek. In babies, this tearing becomes noticeable during the first 2 to 3 weeks after birth.</p><p>Sometimes, the tears may appear to be thicker. The tears may dry and become crusty.</p><p>If there is pus in the eyes or the eyelids get stuck together, your baby may have an eye infection called <a test="test" href="./001010.htm">conjunctivitis</a>.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
</div></div><div class="section-body" id="section-3"><p>Most of the time, the health care provider will not need to do any tests.</p><p>Tests that may be done include:</p><ul><li><div>Eye exam</div></li><li><div>Special eye stain (<a test="test" href="./003845.htm">fluorescein</a>) to see how tears drain</div></li><li>X-ray studies to examine the tear duct (rarely done)</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
</div></div><div class="section-body" id="section-4"><p>Carefully clean the eyelids using a warm, wet washcloth if tears build up and leave crusts.</p><p>For infants, you may try gently massaging the area 2 to 3 times a day. Using a clean finger, rub the area from the inside corner of the eye toward the nose. This may help to open the tear duct.</p><p>Most of the time, the tear duct will open on its own by the time the infant is 1 year old. If this does not happen, probing may be necessary. This procedure is most often done using general anesthesia, so the child will be asleep and pain-free. It is almost always successful.</p><p>In adults, the cause of the blockage must be treated. This may re-open the duct if there is not too much damage. Surgery using tiny tubes or stents to open the passageway may be needed to restore normal tear drainage. </p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
</div></div><div class="section-body" id="section-5"><p>For infants, a blocked tear duct will most often go away on its own before the child is 1 year old. If not, the outcome is still likely to be good with probing.</p><p>In adults, the outlook for a blocked tear duct varies, depending on the cause and how long the blockage has been present.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
</div></div><div class="section-body" id="section-6"><p>Tear duct blockage may lead to an infection (dacryocystitis) in part of the nasolacrimal duct called the lacrimal sac. Most often, there is a bump on the side of the nose right next to the corner of the eye. Treatment for this often requires oral antibiotics. Sometimes, the sac needs to be surgically drained.</p><p>Tear duct blockage can also increase the chance of other infections, such as conjunctivitis.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
</div></div><div class="section-body" id="section-7"><p>See your provider if you have tear overflow onto the cheek. Earlier treatment is more successful. In the case of a tumor, early treatment may be life-saving.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Prevention</h2></div><div class="section-button"><button type="submit" aria-controls="section-8" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
</div></div><div class="section-body" id="section-8"><p>Many cases cannot be prevented. Proper treatment of nasal infections and conjunctivitis may reduce the risk of having a blocked tear duct. Using protective eyewear may help prevent a blockage caused by injury. </p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
</div></div><div class="section-body" id="section-Alt"><p>Dacryostenosis; Blocked nasolacrimal duct; Nasolacrimal duct obstruction (NLDO)</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
</div></div><div name="Images" class="section-body" id="section-tnails"><ul class="img-grid group">
<li><img src="//medlineplus.gov/ency/images/ency/tnails/23190t.jpg" alt="Blocked tear duct" title="Blocked tear duct" class="side-img"/><a href="../imagepages/9015.htm">Blocked tear duct</a></li>
</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
</div></div><div class="section-body" id="section-Ref"><p>Dolman PJ, Hurwitz JJ. Disorders of the lacrimal system. In: Fay A, Dolman PJ, eds. <em>Diseases and Disorders of the Orbit and Ocular Adnexa</em>. Philadelphia, PA: Elsevier; 2017:chap 30.</p><p>Olitsky SE, Marsh JD. Disorders of the lacrimal system. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. <em>Nelson Textbook of Pediatrics</em>. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 643.</p><p>Salmon JF. Lacrimal drainage system. In: Salmon JF, ed. <em>Kanski's Clinical Ophthalmology</em>. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 3.</p></div></div></section>
<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 7/28/2022</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
</div></div>
<div id="section-version" class="section-body"><p>Updated by: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. </p>
</div></div></section><section><div class="section ency-citation"><div class="section-header"><div class="section-title ency-citation"><div id="citation-how-to"><button><span>Learn how to cite this page</span></button></div></div><div class="sm-live-area hide-offscreen" aria-live="polite">
</div></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Related MedlinePlus Health Topics</h2></div><div class="section-button"><button type="submit" aria-controls="section-mtp" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
</div></div><div name="Related MedlinePlus Health Topics" class="section-body" id="section-mtp"><ul class="side-nav"><li><a href="https://medlineplus.gov/tears.html">Tears</a></li>
</ul></div></div></section></div></div></article>
</div>
<footer>
<div class="provider-box group">
<div class="urac-logo">
<a href="https://accreditnet.urac.org/directory/#/certification/HCP-2/info"><img src="https://medlineplus.gov/images/CertifiedSeal.png"/></a>
<p class="urac-logo-info">Health Content Provider<br>06/01/2025</p>
</div>
<p class="adam-info">
<a href='javascript:urac_open();'>A.D.A.M., Inc. is accredited by URAC</a>, for Health Content Provider (www.urac.org). URAC's <a href='javascript:hwsopen();'>accreditation program</a> is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s <a href='javascript:edpolopen();'>editorial policy, editorial process</a>, and <a href='javascript:ppopen();'>privacy policy</a>. A.D.A.M. is also a founding member of Hi-Ethics. This site complies with the HONcode standard for trustworthy health information: <a href='javascript:honc_open();'>verify here</a>.
</p>
</div>
<p class="adam-info">
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997-2025 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
</p>
<div class="adam-logo">
<a href="https://www.adam.com/about" target="_blank"><img width="49" height="10" alt="About A.D.A.M." src="https://medlineplus.gov/ency/images/ency/ftrAdamlogo.gif"/></a>
</div>
<div id="mplus-footer">
<div class="footer1">
<ul class="secondarynav">
<li><a href="https://medlineplus.gov/about/">About MedlinePlus</a></li>
<li><a href="https://medlineplus.gov/whatsnew/">What's New</a></li>
<li><a href="https://medlineplus.gov/sitemap.html">Site Map</a></li>
<li><a name="contact" target="_blank" href="https://support.nlm.nih.gov/knowledgebase/category/?id=CAT-01231&amp;category=medlineplus&amp;from="><span>Customer Support</span></a></li>
</ul>
<ul class="follow-footer">
<li><a href="https://medlineplus.gov/rss.html" class="follow-item">Subscribe to RSS<img src="https://medlineplus.gov/images/feed.png" class="social-media-toolkit-icon" alt="RSS" title="RSS"></a></li>
<li><span class="follow-label">Follow us</span>
<a href="https://twitter.com/medlineplus" class="follow-item" target="_blank"><img src="https://medlineplus.gov/images/i_share_twitter.png" class="follow-icon" alt="X" title="X"></a>
<a href="https://facebook.com/Mplus.gov/" class="follow-item" target="_blank"><img src="https://medlineplus.gov/images/i_share_fb.png" class="follow-icon" alt="Facebook" title="Facebook"></a>
<a href="https://www.instagram.com/mplusgov/" class="follow-item" target="_blank"><img src="https://medlineplus.gov/images/Instagram_Glyph_Gradient_RGB.png" class="follow-icon" alt="Instagram" title="Instagram"></a>
</li>
<li><a href="https://medlineplus.gov/social-media-toolkit/" class="social-media-toolkit-item">Social Media Toolkit<img src="https://medlineplus.gov/images/i_social_media_toolkit.png" class="social-media-toolkit-icon" alt="Social Media Toolkit" title="Social Media Toolkit"></a></li>
</ul>
</div>
<div class="footer2">
<ul>
<li><a href="https://www.nlm.nih.gov/web_policies.html" target="_blank">NLM Web Policies</a></li>
<li><a href="https://medlineplus.gov/about/using/usingcontent/" >Copyright</a></li>
<li><a href="//medlineplus.gov/accessibility.html">Accessibility</a></li>
<li><a href="https://medlineplus.gov/about/using/criteria/">Guidelines for Links</a></li>
<li><a href="//medlineplus.gov/plugins.html">Viewers &amp; Players</a></li>
<li><a href="https://www.hhs.gov/vulnerability-disclosure-policy/index.html" target="_blank">HHS Vulnerability Disclosure</a></li>
<li><a href="https://medlineplus.gov/medlineplus-connect/">MedlinePlus Connect for EHRs</a></li>
<li><a href="https://medlineplus.gov/about/developers/">For Developers</a></li>
</ul>
<div class="address">
<a href="//www.nlm.nih.gov" target="_blank">National Library of Medicine</a>
<span>8600 Rockville Pike, Bethesda, MD 20894</span>
<a href="//www.hhs.gov" target="_blank">U.S. Department of Health and Human Services</a>
<a href="//www.nih.gov" target="_blank">National Institutes of Health</a>
</div>
<div class="return-top"><a href="#top" title="Return to top"><img class="return-top-icon" alt="Return to top" src="https://medlineplus.gov/images/return-top.png"></a></div>
</div>
</div>
</footer>
</div><!-- End Wrap -->
<script src="https://medlineplus.gov/jslib/jquery-3.6.0.min.js" type="text/javascript">
</script>
<script src="https://medlineplus.gov/jslib/mplus-frontend-controls.js" type="text/javascript">
</script>
<!--[if lte IE 9]>
<script src="https://medlineplus.gov/jslib/jquery.placeholder.js" type="text/javascript"></script>
<![endif]-->
<script src="https://medlineplus.gov/jslib/mplus-share.js?id=1112022" type="text/javascript">
</script>
<script src="https://medlineplus.gov/jslib/control.js" type="text/javascript">
</script>
<script src="https://medlineplus.gov/uswds/js/uswds.min.js" type="text/javascript">
</script>
<script src="https://medlineplus.gov/jslib/ency/ency.js" type="text/javascript">
</script>
</body>
</html>