Blocked tear duct

Blocked tear ducts are common in babies, affecting approximately 6% of infants. It can be a nuisance, but it is harmless and almost always goes away by itself without any treatment. It is present at birth, but since most babies do not make many tears until they are several weeks old, the symptoms do not usually appear until then. The condition is also called nasolacrimal duct obstruction (NLDO) or dacryostenosis.

What are the symptoms?

  • Watery eye or eyes; the tears overflow onto the skin most of the time. It will be worse with crying.
  • Watering may be intermittent and happen only with nasal congestion, crying, or when exposed to cold air.
  • There may be some crusting of the eyelids or in the corners after sleeping. There may be some yellowish mucous in the inner corner of the eye.
  • No eye redness and no constant yellow or thick discharge. No eyelid swelling.
  • Sometimes the edge of the eyelid is slightly red and irritated.

What causes a blocked tear duct?

The tear ducts drain tears from the corner of the eye into the nose. It is a constant process. In some babies, the duct is not fully open at birth, and tears can build up in the eye.

What should I expect?

It usually is first noticed around 3-6 weeks of age when tear production increases. The eye will appear wet, with tears overflowing onto the cheek. In some children, it may be partially blocked, and symptoms occur intermittently. It can be worse if mucous and swelling in the nose slow the drainage of the duct.

Blocked tear ducts usually go away without treatment by 6-12 months of age. If it has not resolved by 6-7 months of age, your child should see an ophthalmologist. They can perform a simple procedure to open the duct surgically.

There is a slightly higher risk of eye infection with a blocked tear duct. Your child should see a doctor if the whites of the eyes become red, there is yellow discharge, or there is swelling of the inner corner of the eyelid. These symptoms may indicate a bacterial infection requiring treatment with antibiotic drops or ointment .

How is it treated?

  • Wipe the eyes as necessary to remove any crusted drainage or dry the skin.
  • Massaging the duct may be helpful. Start at the inner corner of the eyelid and press downward. You can use a cotton swab or your finger. Wash your hands before massaging the duct, and be gentle as you massage it. You may see some fluid come out of the opening in the corner of the eye.

What complications should I look for?

  • Eye infection (whites of the eyes are red, increased yellow-green discharge, swelling of the eyelids or the inner corner of the eye)
  • A red lump appears at the corner of the eyelid or a bluish lump under the skin below the eye

How can blocked tear ducts be prevented?

There is no known way to prevent them.

For more information

American Association for Pediatric Ophthalmology & Strabismus. Nasolacrimal Duct Obstruction

MedlinePlus. Blocked tear duct

References

Macewen CJ, Young JDH. Epiphora during the first year of life. Eye. 1991;5(5):596-600. doi:10.1038/eye.1991.103

Sathiamoorthi S, Frank RD, Mohney BG. Spontaneous Resolution and Timing of Intervention in Congenital Nasolacrimal Duct Obstruction. JAMA Ophthalmology. 2018;136(11):1281-1286. doi:10.1001/jamaophthalmol.2018.3841

Kushner BJ. Congenital Nasolacrimal System Obstruction. Archives of Ophthalmology. 1982;100(4):597-600. doi:10.1001/archopht.1982.01030030599010

Pediatric Eye Disease Investigator Group. Resolution of Congenital Nasolacrimal Duct Obstruction With Nonsurgical Management. Archives of Ophthalmology. 2012;130(6):730-734. doi:10.1001/archophthalmol.2012.454

Last updated: 5/7/2022
2/17/2014