What is a blocked tear duct?
The tear duct (nasolacrimal duct) is a small tube that connects the inner corner of the eyelid to the inside of the nose. When our eyes are dry or detect dirt or a foreign body on the surface, they protect themselves by producing tears to moisturise the area and to clean the eyes. Babies eyes are not able to do this immediately after birth and can take up to 14 days. It is thought that 20% of babies are born with tear ducts (in either one or both eyes) that are not able to open fully and are referred to as ‘being blocked’.
If your baby has blocked tear ducts, it means that any tears which the eye produces cannot drain away and you will be able to see tears resting on the corners of the eye or flowing down your baby’s cheeks. This may be visible at any time, not just when your child is upset or distraught. Many find that going out in the wind, colder weather or having a virus can make symptoms worse and more obvious. Some parents find that their child often wakes with crusty or sticky eyes. Babies with blocked tear ducts are also likely to be prone to eye infections.
What should I do?
Most babies with blocked tear ducts will find they clear naturally on their own within 12 to 15 months and having a blocked tear duct does not cause any problems later in life. However, there are a few things that you can do to help your baby be more comfortable during this time. You will find that baby’s skin is likely to be constantly damp and so you should try and dry the area by patting the area with a soft, dry cloth, you should keep the area moisturised and could use a barrier cream.
You should regularly clean your baby’s eyes by using cotton wool and cooled boiled water. It is important to wipe from the nose, outwards across the eye and only do one wipe with each piece of cotton wool, making sure that you wash your hands thoroughly afterwards.
If your baby wakes with a crusty or sticky appearance, you should carefully clean the area and calm your baby. You should try and check the eye area visually regularly as it is possible that your baby will be more prone eye infections or conjunctivitis which may require medical advice or antibiotics.
You should inform your midwife or health visitor that your baby is showing symptoms of blocked tear ducts as they may encourage and teach you to gently massage the area as this can help open the tear ducts. Usually, this involves firstly ensuring your hands are clean and nails are short are smooth. Then, using your little finger, you will be advised to apply pressure next to the inner corner of the eyelid and the bridge of the nose and you will be taught to slide your finger down towards the mouth. Your health professional will advise you how often this should be completed but it is usually no more than ten strokes at a time and no more than twice a day. It is very important to follow the guidance given to you in person from your healthcare professional.
What happens next?
If the tear duct is not fully open after 12 months and problems regularly persist with regular eye infections, your doctor may refer you to an eye specialist. You may be advised for your child to have an operation to clear the tear duct to prevent further build ups and infections. The operation is performed under general anaesthetic, however it is a short day case operation where a tiny probe is used to open the tear duct. Blocked tear ducts can still clear naturally until your child is 5 years old, so operations are only undertaken if the child is regularly suffering or distressed from the blocked tear duct.