Blocked Tear Ducts In Infants

(Nasolacrimal Duct Obstruction, a.k.a. Dacyrostenosis)

McKenzie Pediatrics, April 2007

Many newborns will temporarily have what is known as Nasolacrimal Duct Obstruction, where one or both of their tear ducts are blocked or incompletely open. This leads to:

• Frequent or continuous watery eye(s)
• Tears running down the face even when not crying
• During crying, nostril on affected side remains dry
• Matting of the eye with white to yellow mucous upon awakening
• Possible white to yellow mucous drainage from the eye even while awake

This condition may be present at birth, or become apparent within the first month of life, since the production of tears often doesn’t begin until age 2-4 weeks. Over 90percent of newborns with this condition spontaneously resolve, usually before 6 months of age. If the condition hasn’t resolved by 9 months of age, a consultation with an ophthalmologist is necessary to discuss surgical correction.

While annoying to parents, this condition is rarely noticed by the infant. Parents can help the problem somewhat by performing tear duct massage several times a day, especially before naps. This is where the parent takes a cotton ball, lightly wets it with lukewarm water, and rubs the area just below the eye and next to the nose in a circular motion to “unblock” the tear duct. Then the parent wipes upward and outward across the eye. While not curative, this may help improve drainage into the tear duct during sleep. Otherwise, just carefully keep wiping the drainage away with a washcloth wet with warm water.

Blocked tear ducts may become infected. Call our office if:

• Green drainage is noted from the eye, or green matting of the eyelids is noted
• The white of the eye begins to appear red and inflamed
• The area between the nose and just below the affected eye appears swollen and inflamed
• A fever above 100.4 F develops in an infant less than 2 months of age

Simply for green drainage, or a red and inflamed eye, your infant may be prescribed antibiotic eye drops or ointment. These should be used for a day longer than it takes for the drainage to resolve. Call the office if there is no change after three days of using the medication.