Tearing is a natural function of the eye and it serves the purpose of lubricating and cleaning your eye. Tears are made in the lacrimal glands (see image to the right). From the lacrimal glands, tears drain through two openings at the inner corner of the eyelids. They then drain to the back of the nose via a larger passage called the tear duct (nasolacrimal duct).
In newborns, this tear duct can be obstructed, which prevents the tears from draining normally and this can lead to infection. The medical name when this tear duct is obstructed is congenital lacrimal duct obstruction, where ‘congenital’ means that it is present at birth.
In adults the causes of tear duct blockage are many, but in newborns the cause of the blockage is that the tear duct is not fully developed at birth or that they developed abnormally. Genetics can play a role in this as well.
In many cases, the duct will open on its own without intervention. Therefore, Dr. Walid Abdalla recommends waiting until the child reaches 6 to 12 months of age before considering tear duct surgery.
Since newborns don’t produce tears until several weeks old, a blocked tear duct tear duct may be undetectable.
Some of the signs that your baby may have a blocked tear duct:
- Constant tearing and pooling of tears.
- Redness, swelling or fever due to an infection.
- Crusting around the baby’s eyelids.
- Mucus or pus discharge in the babies eyes.
Symptoms for a blocked tear duct have commonalities with other conditions. So be sure to bring your child to the Orbit eye Center to get a proper diagnosis by an experienced pediatric ophthalmologist.
As mentioned, the problem of an obstructed tear duct can resolve itself within the first year of age. In the meantime, Dr. Walid Abdalla recommends:
- Massaging the inside corner of the baby’s nose 2-3 times a day. This is to ease symptoms and encourage the opening of the blockage.
- Antibiotic eye drops.
- Oral antibiotics in cases of infection.
If the blockage is not resolved during this period, a tear duct surgery would be the next step.
There are three types of surgeries are available to do at the Orbit Eye Center:
- Nasolacrimal duct probing. This is a simple, pain free, yet delicate procedure and usually takes 5 to 10 min to perform while the baby is asleep. In most cases (90%) this procedure is successful,
- If the obstruction is still not resolved after the procedure. then a silicone tube is inserted in the duct to keep it open.
- Dacryocystorhinostomy. This is surgery to make a new opening in the tear sac and through the bone into the nose. This lets the tears drain into the nose.
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