Blocked Tear Duct

What is a blocked tear duct?

When the pathway that normally carries tears from the eye to the nose is blocked, it is called a blocked tear duct. This happens often in very young babies. Most of the time, only one tear duct is blocked at a time.

Your child may have a blocked tear duct when:

• One eye is always watery.
• Tears run down the face even when your baby does not cry.
• When crying, the nostril on the blocked side is still dry.
• The eye on the blocked side is not red, and the eyelid is not swollen.
• The problem starts before your child is 1 month old.

Although the blockage was present at birth, your baby may not have symptoms right away. This is because in some babies, tear production is sometimes delayed until 3 or 4 weeks of age.

How long does it last?

This is a common condition, affecting 6% of newborns. Both sides are blocked 30% of the time. Over 90% of blocked tear ducts open up spontaneously by the time a child is 1 year old. If the blockage continues after age 1 year, an ophthalmologist (eye specialist) can open it with a probe.

How can I take care of my child?

Massage the lacrimal sac (where tears collect) twice a day to empty it of old fluids. Always wash your hands carefully before doing this. The lacrimal sac is in the inner, lower corner of the eye. Start at the inner corner of the eye and gently press upward, using a cotton swab. A small amount of clear fluid should come out.

The massage technique is somewhat controversial. Some physicians recommend massaging downward instead of upward in hopes of washing out the plug that blocks the lower duct. Some physicians recommend not massaging the sac at all. Massage in either direction must be done gently, since it may irritate the eyelid tissue and contribute to infection.

Because of poor drainage, eyes with blocked tear ducts become easily infected. The infected eye produces a yellow discharge. If the eye becomes infected, it is very important to begin antibiotic eyedrops and to stop the massage.

When should I call my child's health care provider?

Call IMMEDIATELY if:

• The eyelid becomes very red or swollen.
• A red lump appears at the inner lower corner of the eyelid.

Call during office hours if:

• Lots of yellow discharge occurs.
• The eye is still watering after your child is 1 year old.
• You have other concerns or questions.