Blocked Tear Duct

Crying is a natural part of infancy and childhood. In addition to expressing emotions, tears lubricate the eyes and keep them free from dust and other foreign particles. Since the lacrimal system, which produces tears, is not fully developed at birth, it usually takes several weeks before healthy babies produce enough tears to flow out of the eyes.

Tears are formed by the lacrimal gland, located in the outer portion of the upper lids. The tears flow down and across the eyes and are collected in small channels located at the inner corner of the eyelid, where upper and lower lids meet. Through these channels, the tears enter a sac (the lacrimal sac) from which they flow through a thin canal (the lacrimal duct) into the nose.

Blocked tear ducts are fairly common in newborns and young babies; they affect as many as six percent of all healthy infants born. The good news is that, properly treated, 90 percent of all cases resolve without surgical treatment by the time babies are 12 to 18 months old.

WHEN SHOULD I SUSPECT THAT MY BABY HAS A BLOCKED TEAR DUCT?
You may notice that one or both of the baby's eyes appear excessively teary over the course of several days. There may be a mucuslike discharge, swelling and/or redness. The baby may seem to be experiencing eye discomfort or pain, and may be difficult to console.

WHAT CAUSES A BLOCKED TEAR DUCT?
In newborns a blocked tear duct is usually due to a minor birth defect in which the membrane covering the tear duct at birth does not disappear. As a result, the duct opening is not formed. A cyst can also block a tear duct, as can an infection or trauma.

IS MEDICAL ATTENTION NECESSARY?
It is important to consult your pediatrician promptly if you suspect the baby has a blocked tear duct. If left untreated, tears can accumulate in the lacrimal or tear sac, which can become infected by bacteria. The infection can spread into adjacent areas, such as the sinuses or adenoids. A physical examination of the child's eyes will be necessary to diagnose the problem and treat the underlying cause.

WHAT TREATMENTS ARE AVAILABLE?
The pediatrician will probably show you how to massage the ducts to clear the obstruction.

Placing warm, moist compresses over the eyes may also be recommended. The pediatrician should show you how to clear the baby's eyes of secretions. If the tear-duct obstruction has caused an infection, antibiotic ointment or drops are usually prescribed.

In some cases, these treatments are inadequate, and an ophthamologist should be consulted. As a last resort, surgery may be necessary to remove a cyst or open a blocked duct.

COPING WITH BLOCKED TEAR DUCTS
Carefully follow your pediatrician's instructions for massaging the tear duct and clearing the baby's eyes. Always wash your hands before touching your child's eyelids, and rinse thoroughly, because traces of soap can increase irritation and tearing.

GETTING HELP
Call your doctor if:

• Your baby has symptoms that suggest a blocked tear duct

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.