Blocked Tear Duct

This is a really common condition, occurring in about 20% of infants in the first month of life. It shows up as a watery, sticky eye that is not swollen or red. It resolves, by itself, in most kids, by one year of age.

What is it?

The watery discharge comes from the incomplete development of the nasolacrimal duct. This means that the channel that normally carries tears from the eye to the nose is blocked. The obstruction to flow is present at birth, but some kids don't make tears until 3 or 4 weeks of age, and therefore don't have symptoms until that time. It occurs most often in only one eye, but can occur in both.

How do I take care of it?

There's plenty of information out there on "tear duct massage," a technique I don't think I'll describe because I can't find anything out there that proves it does anything, and it may, in fact, contribute to infection.

I recommend that you simply keep the eye clean with warm water washes. The drainage stuff can be irritating and lead the child to rub the eye, making it further irritated and perhaps contributing to infection.

We don't need to treat with topical antibiotics (eye drops) unless the eye is red or swollen. The yellow discharge itself isn't necessarily indicative of infection-remember that the color of the drainage rarely ever helps me out.

When should my child be seen?

Since there are other things that can look like a blocked tear duct, and some of them, although rare, need to be treated aggressively, I want to see your child when the drainage first starts, so that we know for sure what we are dealing with. After that, once we are pretty sure that we are only dealing with a blocked tear duct, we won't need to see the baby unless the eye itself is red or swollen (or both!)

What if it's not better by a year?

If it's not resolved by a year of age, then we send you and your child to an ophthalmologist (eye doctor) to see if the duct needs to be probed. The probing is really a "minor" procedure (if any procedure can be on your little one) as it doesn't even require general anesthesia. Most children will have spontaneous resolution of the problem, so we rarely have to go to this step. Unfortunately, we don't have a way, yet, to predict whose congenital nasolacrimal duct obstruction will go away by itself and which ones will need probing. I can tell you that there isn't a correlation between how severe the obstruction is and when it will go away.