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Blocked tear ducts in babies

What is the tear duct?
The tear duct (nasolacrimal duct) is a tiny passage running from the inner corner of the eyelids to the inside of the nose. It drains away the tears and mucus that the eye constantly produces.

What is a blocked tear duct?
One in five babies is born with a tear duct that is not yet open in one or both eyes. This can cause watery or sticky eyes.

Is it serious?
No. The problem does not damage the eyes or the vision and is harmless. In most babies, the condition clears by itself before they are one or two years old.

Possible problems
The eyelid skin may become sore because of the constant wetness. The eye may sometimes be slightly pink, but no treatment is needed for this. Occasionally, there may be conjunctivitis (red, inflamed eye) which may require antibiotic drops. Very rarely, the tear sac can become swollen and infected (dacryocystitis). A tender red lump or swelling appears in one inner corner of the eyelids. In either of these situations you may need a review by a healthcare professional.

What treatment is needed?
Keep the skin clean and dry using cotton wool and clean water. If the skin becomes sore, apply Vaseline to cleaned, dry skin to protect it. Tear duct massage, by applying firm pressure to the inner corner of the eyelids several times per day, may help clear the blockage. Eye drops are not required, even if the discharge is mucky, unless the eye itself is very red.

When should an operation be done for blocked tear duct?
If a blocked tear duct does not improve after the age of one year, and the symptoms are bad enough, probing of the tear duct can be performed under general anaesthesia. But in most cases, it is safe to wait longer – many of the symptoms still improve with time alone. If the blocked tear duct does not get better after one year of age and you wish to consider an operation, please ask your GP to refer your baby to the clinic.