Does Your Baby Have a Blocked Tear Duct?

August 7, 2013


Baby with Blocked Tear Duct

Babies enter the world with a cry, but they do not begin producing tears until they are about three weeks old.  The tears, which are necessary for the natural lubrication of the eyes, flow through a serious of drainage channels that carry the fluid on into the nose.

A baby who has noticeable watering of the eyes, with tears overflowing from the lids onto the cheeks, probably has a blockage in the tear drainage system.  Actually, this problem is very common, occurring in about one out of three babies.  Most of the time it corrects itself completely.  If not, it can be corrected with a simple procedure.

 Symptoms of a Blocked Tear Duct

Excessive watering of the eyes may occur even when your baby is not crying.  The eyelashes may have crust and mucus on them, particularly in the morning.  If there is some infection, which is made more likely by the abnormal backup and pooling of tears, the eyes may become red and the lids swollen, perhaps even with a thick yellow discharge.

What Causes the Tearing?

Tears normally drain from the eyes through tiny tube-like channels called canaliculi, which are located under the skin at the inner corner of the upper and lower eyelids.  These channels carry the tears into the tear sac, near the side of the nose, and then into the tear duct, which empties into the nose.  (That’s one reason your nose runs when you cry.)

In most newborns, the place where the tear duct enters the nose is covered by a thin membrane that blocks the opening.  This membrane usually opens spontaneously within the first six weeks of life, but in some babies it doesn’t open until much later.  In others the membrane needs some help to become unblocked.


Most infants who have a blocked duct during the first year of their life will get better on their own without any treatment, but you can help speed the process along by massaging carefully over the tear sac.

How to massage:  You can find the tear sac by placing your index finger firmly on the inner corner of the baby’s eyelids, close to the nose.  You will feel a ridge of bone under your finger.  Press down gently but firmly toward the nostril and hold it for 3 to 4 seconds.  Do this 3 or 4 times a day.  (Be sure your fingernails are short!)  If you do not understand these instructions, someone in the office will go over them with you.  There is also a technique involving the use of a cotton swab which our staff can teach you

If eye infections accompany the tearing, antibiotics may be prescribed.

If the tearing problem does not improve after allowing sufficient time for the natural opening process and the massaging to work, or if frequent infections occur, the tear duct may need to be opened with a “probing”.

What Is Probing Like?

A thin metallic instrument is slipped into the tear duct and pushed through the membranous block.  The probe acts like a pipe cleaner to remove the obstruction.  This is a painless, minor procedure that usually takes less than five minutes.  If the baby is older than 6 months, the procedure will usually be performed in the hospital operating room, since general anesthesia may be needed to keep the baby from moving while the delicate channels near the eyes are being probed.

Except for the time in the operating and recovery rooms, you will be able to stay with your baby, and he or she can go home with you the same day.

Occasionally a baby develops a mild nosebleed after returning home.  If bleeding is any more than a few drops, please call the office right away.


Probing a tear duct is generally quite safe and can provide an immediate cure.  In a very small number of children, however, it may not work because of some other abnormality of the tear drainage system.  In that case, additional procedures will be required to allow tears to drain properly.

If any type of surgical procedure is recommended for your baby, the risks, which are present with any surgery and anesthesia, will be carefully explained to you along with the potential benefits.

Fortunately, tearing problems arealmost always managed simply and successfully

Excerpted from All About Vision.

Dr. Jeffrey Gold is the medical director of Liberty Vision in Hamden CT. The award winning surgeon has recently been named Best LASIK surgeon in a New Haven Advocate Readers' Poll.