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“My baby tears up continuously. What’s the matter?” – A question that parents ask their paediatrician frequently. This is called watery eyes and the most common cause for it is the obstruction of the tear duct.  

What is the tear duct?

In the eye there are glands that produce tears, which constantly keep the front surface of the eye moist. The tears are then led through the tear duct to the nose. The lacrimal duct is a small tube that starts in the inner corner of the eye and ends in the nose. 

What are the causes of tear duct obstruction?

Many children are born with a blocked tear duct. In most cases there is no complete blockage, but it is a little narrower than normal. In some cases, however, the tear duct is closed by a thin membrane. In these cases, there is a high probability that surgery will be needed. Rare causes of tear duct obstruction are polyps and nasal tumours. In addition, injury to the eye and nose area can then cause blockage of the tear duct. 

What are the symptoms of blocked tear duct in a baby?

Symptoms do not always begin at birth but can be delayed until the age of 12 weeks. This is due to the fact that the production of tears in the first days of life is reduced. When there is a blockage, the child’s eye constantly runs a watery liquid (tear), even when they are not crying. Then you may notice that pus runs from the eye and in the morning when the child wakes up his eye is full of mucus. Sometimes a tear sac infection can occur and then you will notice redness on the inner area of the eye. 

What is the treatment of the closed tear duct?


Your paediatrician or ophthalmologist who will examine the child may recommend that you massage the child's eye. CAUTION: Remember to always wash your hands before the massage. Place the index finger of your hand on the corner that forms the eye with the nose and massage the area from top to bottom for a while.

In case your baby's eye becomes infected, then your doctor will prescribe some antibiotic eye drops.

If the tear duct blockage persists then the ophthalmologist may recommend opening it surgically. The operation is ideal to be done between the age of 8-12 months. The success rate of unblocking the tear duct at this age is 85-95%. As the child grows, the success rate lowers. The operation is simple, has a short duration and is performed under general anaesthesia. It is best done by a paediatric ophthalmologist who has more experience in operations on children. The surgeon inserts a very thin metal tube into the duct and then inserts saline water to make sure it is open.

Tips to parents

In case of any of the following you should contact your doctor 

The eye is swollen or even red.

When you notice a red mark in the corner of the eye.

The eye presents a yellow purulent fluid.
Authored by Dr. Adamos Hadjipanayi, Paediatrician