Question:
I have cultured positive for strep in throat. The next day, my sinuses became inflamed and when I blew my nose, I had snot coming out of eyes and it also burned my eyes. Is this normal?
Answer:
While this is not what one would consider “normal”, it certainly can happen with a sinus infection (sinusitis).
Strep can not only cause a throat infection, but is a common bacteria causing sinusitis. When you get a sinus infection it is because the lining of the nose gets so swollen that the sinuses can’t drain. Typically the musus from sinusitis drains through the nose.
However, there are other “tubes” that drain into the nose, which can also get blocked in the same way. The eustachian tube drains the middle ear fluid into the back of the nose. If this gets blocked from swelling or congestion in the nose, fluid builds up in the space behind the ear drum and you can get a middle ear infection. (acute otitis media) This is quite common in children, because their eustachian tubes are shorter, more horizontal and often also blocked partially by adenoids (lymph tissue in the back of the nose). Adults can get this, of course, also.
The tear ducts are another set of tubes that drain into the nose. If they get blocked, we often tend to feel that we are making excess tears- as our normal tears can’t drain. If you blow your nose and the nose is congested- or hold the nose too tightly when you blow- mucus from the nose can go the other way- through the tear ducts and around the eye. This is likely what is going on in your case. Be careful not to blow the nose too forcefully while your nose is congested as the mucus from sinusitis can cause you to get conjunctivitis (pink eye).
I hope this clears things up.
Robert L Pincus MD
Co-Director NY Sinus Center
Frequently Asked Questions
Yes, strep bacteria can cause not only throat infections but also sinusitis. When the sinuses become infected, the lining swells and prevents normal mucus drainage, leading to symptoms like nasal congestion and inflammation.
The tear ducts drain tears into the nose. If the nose is congested or you blow your nose forcefully, mucus can back up through the tear ducts, causing mucus to exit near the eyes. This explains mucus coming out of your eyes when blowing your nose during sinusitis.
While not typical, sinus infections can cause swelling and congestion that block tear duct drainage, leading to eye discomfort and burning sensations. This occurs because the mucus or inflammation affects nearby structures connected to the eyes.
A blocked eustachian tube prevents fluid from draining the middle ear into the nose, leading to fluid buildup behind the eardrum. This can result in a middle ear infection (acute otitis media), which is especially common in children but can affect adults too.
Blowing your nose too forcefully when congested can push mucus through the tear ducts and lead to contamination of the eyes with infectious mucus. This increases the risk of conjunctivitis (pink eye) and eye irritation.
Children have shorter, more horizontal eustachian tubes and may have partially blocked tubes due to enlarged adenoids. These anatomical factors make it easier for congestion to cause fluid buildup and middle ear infections in children.
