Ask the Doctor: Blocked Tear Ducts

Q. I noticed that tears well up in the corner of my baby’s eyes when she cries or when I take her out into the cold weather. Now the skin under the eyes is getting red from rubbing. Is this something serious? What can be causing this?

crying baby 300x300 Ask the Doctor: Blocked Tear Ducts PhotoA. You are certainly not alone with this problem. In 6 out of every 100 newborns, the tear ducts are blocked at birth. This condition is called congenital lacrimal duct obstruction or dacryostenosis.

The blocked tear ducts stem from improperly formed openings into the duct in some infants, leading to a blockage involving one or both eyes. Usually this occurs when the thin tissue at the end of the tear duct doesn’t open. Other rare conditions can occur causing blockage:

  • Undeveloped openings where tears flow into the tear ducts
  • Nasal bone growth abnormality closing the ducts from the pressure exerted
  • Infections

 

Symptoms

Symptoms like the type that your baby manifests, start to show within the first few days or weeks after birth, along with excessive tearing, eye glistening or tears running down the cheeks along with swelling or redness around the nose and eyes. These symptoms are exaggerated with exposure to cold temperatures, wind and direct sunlight, and can appear worse with colds, and sinusitis or upper respiratory infections.

Yellow mucus can collect in the corner of the eyes causing the lids to stick together. Infection can occur involving the eyelids and region surrounding the eyes.

Journey of Tears

The lacrimal gland can be found under the bone of the eyebrow. It is here that tears are made. They flow from the gland over the eyes for lubrication and cleaning, through the tiny ducts, which are then drained away from the eye through the two openings at the inner corner of the eyelid.

When the ducts are obstructed or unopened, the tear duct sac fills with fluid, putting a baby at risk for inflammation or infection.

Evaluation

Undergoing a simple physical examination along with analysis of a comprehensive medical history will lead to the proper diagnosis. While the doctor can measure the quantity of tears or see if the tears are properly draining, no further tests are needed.

Treatment

The good news is that no treatment is necessary for babies born with congenital blockage of the tear ducts. While antibiotics may be needed for any infections present (seen with yellow discharge), home therapy can be performed. Massage the tear duct three times daily.

Most obstructed ducts open by themselves within one year of life.

If the duct is still blocked after 1 year of age, (which is not common) your physician can open the duct with a small probe, which is all that is necessary.

So, you see, the condition is harmless and self-limiting in most cases. There’s no reason to cry over unspilled tears!

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