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Blocked Tear Ducts [Read/Print full article]
Overview
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A blocked tear duct occurs when the passageway between the eye and the nose is partially or fully obstructed. It is a common problem in infants, with as many as one-third of infants born with this condition.
Normally, our eyes continually produce tears to protect the eye and keep it moist. The tears usually drain from the surface of the eye through an opening (tear duct) located in the inner corner of the eye and then into the nose. When this tear duct is blocked, the excess tears run out of the eye onto the cheek, which makes it appear that the infant or child is crying when they are not.
A baby might be born with a tear duct that is too narrow or is covered by a web of thin tissue and, therefore, doesn't drain properly or may easily become blocked.
Usually a blocked tear duct resolves on its own with little or no treatment. Most children outgrow this condition by their first birthday. When a blocked tear duct is discovered early, there is less chance that complications, such as infection or a blockage that requires surgery, will occur.
Causes
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Most children who have blocked tear ducts are born without a fully developed tear duct. A baby might be born with a tear duct that is too narrow or has a web of thin tissue blocking the duct. Therefore, the tear duct does not drain properly or is easily blocked. This condition usually resolves without further medical treatment by the child's first birthday.
Blocked tear ducts are rare in older children, but in some cases nasal polyps can cause blockage. Nasal polyps are cysts or growths of extra tissue in the nose near the end of the tear duct.
Symptoms
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Babies with blocked tear ducts normally experience symptoms between birth and 12 weeks of age. In some cases, you will not know that your child has a blocked tear duct until the tear duct becomes infected.
A baby with a blocked tear duct typically has the following symptoms:
- Excessive tearing or a continuously watery eye.
- Tears fill the eye and occasionally run down the face, even without crying.
- Thicker tears than normal (not always present).
Tear ducts in both eyes are blocked in 30 percent of children. If the eye is red and swollen without excessive watering, your child may have conjunctivitis instead of a blocked tear duct.
Signs of infection
It is possible for the fluid that builds up in a blocked tear duct to become infected. Signs of possible infection include:
- Redness at the inner corner of the eye
- Slight tenderness, swelling, or a bump at the side of the nose
- A bluish-colored bump near or around the eye
- Swelling of the eyelids, eye socket, or under the eyebrow
Diagnosis
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Usually, we can diagnose a blocked tear duct by examining your child's eye.
Sometimes, a special eye exam called a fluorescein dye test is needed to confirm the diagnosis. We'll place a drop of eye stain into the affected eye so we can see how the tears drain through the tear duct.
Treatment
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Babies with blocked tear ducts can often be treated at home. If the area is not infected, you can carefully massage the eye several times a day for a couple of months.
Massaging your baby's eye
To massage your child's eye, be sure to wash your hands and then remove any dried tears with a warm, wet cotton ball or washcloth. Next, place your index finger on the side of the bridge of the baby's nose and gently massage down toward the corner of the nose. Carefully apply a warm compress or washcloth to the eye to help promote drainage and ease discomfort.
When using a warm washcloth, make sure to frequently turn the washcloth so that you use the same area of the washcloth only once to clean the eye. Do not use the same washcloth on the other eye.
We may prescribe antibiotic drops for your baby if the eye is becoming infected. It is important that you use these drops as directed. Be sure to clean the eye area with a warm, wet cotton ball or washcloth before administering the drops to ensure that the drops are effective.
Remember that most blocked tear ducts open up on their own. If your child's blocked tear duct does not improve with home treatment or eyedrops, we may need to open it with a small probe. In rare circumstances, we need to place a small tube in the child's tear duct to keep it open.
When to Call Us
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If the baby or child's eye is starting to produce pus, he or she may have developed an eye infection from the blocked tear duct. Call the clinic for an appointment if you notice any of the following symptoms:
- Looking or acting very sick
- Pus in the eye
- Red or swollen eyelid
- Cloudy cornea
- Red lump in the inner corner of the eyelid
- Difficulty moving one or both eyes
- Eye pain or discomfort
Call us as soon as you see an infection starting because it may spread to other parts of the face. An infected, blocked tear duct may lead to an abscess if not treated promptly.
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.