Blocked tear ducts, also called dacryostenosis, could prevent the flow of tears from the eyes. Tears normally drain through the tear ducts from the eyes to the back of the nose. If this passage is blocked or not open, it can accumulate fluid and lead to inflammation and infections.
Although tear ducts can be blocked at any age, babies are most vulnerable. Blocked tear ducts may affect one or both eyes of one out of 20 newborns. Blockage of tear ducts leads to a condition called epiphora – excessive watering of the eye. However, the blocked tear ducts often open on their own in most babies during infancy (1).
Read this post to learn more about the causes, signs, symptoms, complications, diagnosis, and treatment for blocked tear duct in babies.
Causes Of Blocked Tear Duct In Babies
Babies may have blocked tear duct due to various reasons, including (2):
- The failure of the tissue at the last section of the tear duct to open i.e., persistence of a membrane which normally disappears at birth – this is the reason why epiphora is commoner in premature babies as compared to full term babies.
- Nasal bone abnormalities that may cause pressure on the tear duct or compress it
- Inadequately developed or closed opening of the duct near the eye
- Injury of bones or tissues around the tear duct
- Hereditary reasons
Signs And Symptoms Of Blocked Tear Duct In Babies
The severity and duration of symptoms and signs may vary depending on the underlying cause. Although it is common to have blocked tear duct in one eye, some babies may have both eyes involved.
Common signs and symptoms due to blocked tear duct may include the following (3).
- Excessive tearing may cause the eyes to look moist all the time, and tears may often run down
- White or yellow crust around the corner of the eye
- Eyelids may stick due to discharge
- Redness (mild)
You may seek medical care if your baby has any signs and symptoms of tear duct blockage. Even though the blockage occurs at birth in several babies, the symptoms are not apparent until the first month of life. Some babies may develop signs and symptoms within a few days or weeks.
Complications Of Blocked Tear Duct In Babies
Babies who have a blocked tear duct may develop dacryocystitis, an infection of the eye’s drainage system. This may cause redness and edema (swelling) around the nose and eyes. Severe cases of dacryocystitis can result in fever, pain, and pus or mucus formation in the eyes. Sometimes, an infection may spread to the eyelids and cause swelling, making it difficult for the baby to open their eyes (4). If left untreated, rarely dacryocystitis can involve the tissues of the entire eyeball and the optic nerve and lead to vision loss.
Babies with blocked ducts are more likely to develop bacterial, viral, or fungal eye infections since the eyes are inadequately cleansed by tears. It may increase the risk of recurrent conjunctivitis (pink eye).
Upper respiratory tract infections, such as sinus infections (sinusitis) and cold, may exacerbate the symptoms of a blocked tear duct. Sun exposure, wind, and cold weather may also worsen the symptoms of blocked tear duct in babies.
Diagnosis Of Blocked Tear Duct In Babies
Pediatricians may diagnose blocked tear ducts based on medical history and physical examinations. Some tests may be done to measure the number of tears to analyze if the draining of tears is normal. They may order some additional examination to look for the underlying cause (5).
Blood tests may help identify infection markers, and imaging tests, such as an X-ray or CT scan, are often done to visualize sinus tracts.
Treatment For Blocked Tear Duct In Babies
Not all babies with blocked tear ducts require treatment. Doctors may recommend home care methods to prevent infection and other complications until the block resolves.
The following measures are recommended for babies with less severe blockage (6).
- Always maintain good hand hygiene before touching the baby’s eye area.
- Wipe away eye discharge with a washcloth or cotton ball. You may use lukewarm water to moisten the cloth or cotton ball. It is recommended to gently wipe away from the edge of the eyes and towards the nose.
- You may give them a gentle massage around the eye, known as Crigler massage, two to three times a day as per the doctor’s recommendation. This may help relieve the blockage. Always maintain good hand hygiene before touching the baby’s eye area.
- Limit sunlight, cold weather, and wind exposure to prevent worsening of symptoms.
Other medical treatments and interventions may include the following (4).
- Antibiotics are given to prevent severe infections if the baby has signs of infection.
- Probing procedure may help clear out blocked tear ducts. A probe is used to dilate and irrigate the tear duct in this
- Severe cases may require intubation or stenting of the tear duct to open it.
- Complex surgeries, such as dacryocystorhinostomy, to open the blocked tear duct might be performed later in life if needed.
Conservative management and non-invasive medical interventions are usually enough to open blocked tear ducts in most babies. Babies with structural anomalies or abnormal growths usually require surgical interventions.
In many cases, the pediatrician may recommend to wait and watch for a few months since blocked tear ducts may open on their own as the baby grows older. However, if obstruction persists beyond one year of age spontaneous resolution is unlikely and surgery is advised .
Blocked tear ducts often resolve during infancy and do not cause permanent eye damage. New research is now showing that about 10% of children with tear duct obstruction at birth may have subsequent disorders of refraction (difficulty in vision). It is thus a good idea to get them periodically assessed by an ophthalmologist as per the schedule suggested by the doctor.
2. Blocked Tear Ducts; C.S. Mott Children’s Hospital
3. Tear Duct- Blocked; Seattle Children’s Hospital
4. Blocked tear duct; St. Clair Hospital
5. Blocked Tear Duct (Dacryostenosis) in Children; University of Rochester Medical Center (URMC)
6. Blocked Tear Duct (Infant); Fairview