It’s tough to see your baby suffer. And even tougher to figure out what is causing their suffering! If only they could tell you what the problem is. When you see excessive tears, your baby may be suffering from a blocked tear duct. But how do you know whether this is the problem? And what can be done to solve it?
Tear duct anatomy
Tears are vital to keeping the surface of the eye healthy. They serve to moisturize the eyes for comfort and flush the eyes throughout the day. They also support clear vision by providing a stable optical surface for light to pass through.
As tears are continuously produced, there must also be a route for them to leave the eye. They start their course out of the eye from tiny holes in the eyelids before flowing through a larger passage ultimately leading to the nose.
There are four key parts of the ductal system through which tears drain out of the eye: the puncta, the canaliculi, the nasolacrimal sac, and the nasolacrimal duct. A blockage in any one of these parts can obstruct tear outflow.
Tear duct blockage
Dacryostenosis is the term used to describe a blockage in the tear duct system. The word comes from the Greek words dákryon (tear) and stenósis (narrowing).
One can be born with dacryostenosis, in which case it’s called congenital.
Dacryostenosis can also develop with time, in which case it’s called acquired.
Regardless of whether it’s congenital or acquired, a blocked tear duct causes an overflow of tears, or epiphora.
Blocked tear duct in children
Congenital dacryostenosis is the most common reason for persistent tearing and discharge in infants and young children. One study found that 20% of babies experience problems with tear drainage in the first year of life.
The blockage in the tear duct may be constant, or it may come and go.
Although the tear ducts may not have initially formed properly, they will usually open up on their own by the time the child is a year old.
What are the symptoms of a blocked tear duct?
As your child may not be able to verbalize their symptoms, here’s what you’ll want to look out for:
- Tears pooling in the corner of their eyes
- Tears draining down their cheeks
- Mucus discharge in their eyes
- Dried crusting on their eyelids and eyelashes
- Redness of their eyes or eyelids, from rubbing
One or both eyes may be affected. Symptoms are not usually apparent right at birth, as newborns don’t produce tears until they’re a few weeks old.
Most cases of congenital dacryostenosis will resolve on their own in the first year of life.
In the meantime, gently massaging the tear duct two to three times a day can help to facilitate tear drainage and ease any blockage. Use your index finger to massage the area between the inner corner of the eye and the side of the nose. You’ll want to slide your finger in a downward motion on the side of the nose. Your doctor can help to demonstrate this procedure.
In the case where a blocked tear duct persists after the child’s first year of life, more invasive treatment may be needed.
An eye doctor can use a probe to open up and flush out the tear duct. Sometimes, a stent is placed.
If this doesn’t work, more invasive surgeries may be performed, such as a dacryocystorhinostomy (DCR). A DCR involves removing some of the bony structure to make room for better tear drainage.
If you see your baby’s eyes tearing excessively, they may have a blocked tear duct. This is a relatively common problem in babies. However, it may not be noticeable until the child is a few weeks old, as newborns don’t yet produce tears.
You can help to facilitate tear drainage by using gentle massage with your index finger. Start in the area between the inner corner of the eye and the nose, then slide down the side of the nose in a sweeping motion.
If the problem doesn’t clear up by the age of one, then probing or surgery may be needed.
Blocked tear ducts are rather common in infants, but they generally clear up on their own by the time the child turns one.
Gentle massage of the tear duct at home two to three times a day can help to facilitate tear drainage.
If the problem doesn’t clear up by the age of one, probing or surgery may be needed.
National Library of Medicine. Dacryostenosis.