Clinical Reference Systems: Pediatric Advisor 10.0
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DESCRIPTION

• The eye is always watery.
• Tears run down the face even without crying.
• During crying, the nostril on the blocked side remains dry.
• Symptoms begin before a child is 1 month old.
• The eye is not red and the eyelid is not swollen (unless the soggy tissues become infected).

CAUSE

Your child probably has a blocked tear duct on that side. This means that the channel that normally carries tears from the eye to the nose is blocked. Although the obstruction is present at birth, the delay in onset of symptoms can be explained by the occasional delay in tear production until the age of 3 or 4 weeks in some babies.

EXPECTED COURSE

This is a common condition, affecting 6% of newborns. Both sides are blocked 30% of the time. Over 90% of blocked tear ducts open up spontaneously by the time a child is 1 year old. If the blockage continues after age 1 year, an ophthalmologist (eye specialist) can open it with a probe.

HOME CARE FOR PREVENTING EYE INFECTION

Massage the lacrimal sac (where tears collect) twice a day to empty it of old fluids. Always wash your hands carefully before doing this. The lacrimal sac is in the inner, lower corner of the eye. Start at the inner corner of the eye and gently press upward, using a cotton swab. A small amount of clear fluid should come out.

The massage technique is somewhat controversial. Some physicians recommend massaging downward instead of upward in hopes of washing out the plug that blocks the lower duct. Some physicians recommend not massaging the sac at all. Massage in either direction must be done gently, since it may irritate the eyelid tissue and contribute to infection.

Because of poor drainage, eyes with blocked tear ducts become easily infected. The infected eye produces a yellow discharge. If the eye becomes infected, it is very important to begin antibiotic eyedrops and to stop the massage.

CALL YOUR CHILD'S PHYSICIAN IMMEDIATELY IF:

• The eyelid becomes very red or swollen.
• A red lump appears at the inner lower corner of the eyelid.

CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:

• Lots of yellow discharge occurs.
• The eye is still watering after your child is 1 year old.
• You have other concerns or questions.