Blocked tear ducts can cause great concern in new parents. Read more to find out more about why this problem arises and what to do about it.
Why do blocked tear ducts occur?
Tears are made in the lacrimal glands near the eyebrow area, and they help lubricate the eye and keep it clean. Tears drain out of the eye through small openings at the inner corners of the eyelids.
Tears enter these openings into a tube-shaped duct that moves tears from the eyes to the inside of the nose (that is why people get a runny nose when crying!). This tube is called the nasolacrimal duct but is commonly called the tear duct.
In some babies, the opening into the nasolacrimal duct is not formed properly. That causes tears to have nowhere to drain to, and this causes the appearance of excessive tears in the affected eye. This problem is called dacryostenosis (or blocked tear duct) and can present in one or both eyes.
Symptoms: What does a blocked tear duct look like?
In most cases, a blocked tear duct can be diagnosed by your child’s pediatrician by taking their medical history and doing a physical exam. Occasionally, additional testing may be required to confirm the diagnosis.
It’s important to remember that children may experience symptoms differently. Even though they are born with it, newborns with blocked tear ducts may not experience symptoms during the first days of life because they don’t produce a lot of tears until they are several weeks old.
Common symptoms are:
- An eye that is constantly watery/teary. Tears may pool in the corner of the baby’s eye.
- Tears fill the eye and run down the face even when the baby is not crying.
- You may notice mucus or yellowish discharge in the eye.
- The skin around the eye may be slightly reddish from rubbing, but it should not be very red or swollen.
- Almost 1/3 children with blocked tear ducts have this problem in both eyes.
How to manage a blocked tear duct
The good news is, blocked tear ducts do not need treatment and most resolve on their own before the child’s first birthday. If you believe your child has a blocked tear duct but has never had it checked out by their doctor, make sure to confirm the diagnosis with their doctor before deciding to wait it out.
Lacrimal sac massage
Some doctors recommend lacrimal sac massage (where tears collect). Other doctors don’t recommend it. Massage is not required to make the tear duct open. The tear duct will open with time even if you don’t do it.
If you have been recommended to do tear duct massage, here are some tips on how to do it.
- Make sure everything is clean.
- The lacrimal sac is in the inner corner of the lower eyelid.
- A lint-free cotton swab works better than the finger because it is smaller.
- Start at the inner corner of the eye and press upward very gently. Fluid and mucus should come out of the lacrimal sac.
- Do this twice a day.
Remember that the blockage in the lacrimal duct is not simply a bit of mucus that go stuck in there. The baby was born with this narrow passage and removing the “gunk” is not enough to unblock it. The lacrimal duct continues to develop during the first year of life and it will open by itself in 90% of babies before they turn 12 months.
When it doesn’t resolve
You may be wondering… if 90% of cases resolve spontaneously by age 1, what happens to the other 10% of babies?
Certainly, in some cases, babies turn 1 and the tear duct continues to be blocked. In these cases, the baby will probably need to see an eye doctor. In these cases, sometimes a procedure to enlarge the duct with a small probe is necessary. Here’s a video that explains the probing procedure.
The procedure with the probe is very effective in most cases but in some babies, it needs to be repeated. Surgery may be an option when all other options have failed.
When to seek medical care
If your child has not yet been officially diagnosed with dacryostenosis (blocked lacrimal duct), and you think this might be going on, definitely get an evaluation from your child’s pediatrician.
If your baby has a confirmed diagnosis there are other things to look out for. You should know that eye infections, unfortunately, are very common in babies with a blocked tear duct. An eye infection will have pus in the eye and eyelids stuck together.
If your baby’s eyes look like they are becoming infected with pus, they must be evaluated to determine the need for antibiotic eye drops. Every time you see dry or liquid pus, remove it with warm water and wet cotton balls. If antibiotic drops are prescribed, make sure to clean any pus from the eye as described above, before putting the drops into the eye.