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Tear Duct - Blocked

Definition

  • Blocked tube that normally carries tears from the eye to the nose
  • It's blocked in 10% of newborns
  • Use this guide only if a doctor has told you it's a blocked tear duct

Symptoms of a Blocked Tear Duct

  • A constant watery eye
  • Tears fill the eye and run down the face. This happens even when not crying.
  • The eye is not red and the eyelid is not swollen.
  • Both sides are blocked in 30% of these children.

Cause of a Blocked Tear Duct

  • Caused by blockage of the lacrimal duct. This duct carries tears from the corner of the eye to the nose.
  • A watery eye may not be noticed until 1 or 2 months old. Reason: that's when the eye starts making more tears.

When To Call

Call Doctor or Seek Care Now

  • Eyelid is very red or very swollen
  • Clear part in the middle of the eye (cornea) is cloudy
  • Fever in baby less than 12 weeks old. Caution: Do NOT give your baby any fever medicine before being seen.
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Red lump at inner corner of eyelid
  • Eyelid is red or swollen
  • Pus in the eye
  • You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Diagnosis has never been made by a doctor
  • Age more than 12 months old
  • You have other questions or concerns

Self Care at Home

  • Blocked tear duct

Care Advice

What You Should Know About Blocked Tear Ducts:

  • A blocked tear duct is common. It happens in 10% of newborns.
  • Both sides are blocked 30% of the time.
  • A blocked tear duct does not need treatment unless it becomes infected.
  • Here is some care advice that should help.

Antibiotic Eyedrops for Pus in the Eye:

  • Pus in the eye or eyelids stuck together means the eye is infected.
  • This is common with blocked tear ducts. It should clear up in a few days with antibiotic eyedrops.
  • For pus in the eye, call your child's doctor for a prescription.
  • In the meantime, here is some advice that should help.

Remove Pus:

  • Remove the dried and liquid pus from the eyelids with warm water and wet cotton balls. Throw away after use.
  • Do this each time you see pus.
  • Also, clean the eyes before you use the prescription eyedrops. The eyedrops will not work unless the pus is removed first.

Compression (Massage) of Lacrimal Sac - Do it Carefully:

  • Some doctors suggest compression (massage) of the lacrimal sac where tears collect. Other doctors do not. Compression is not required. The tear duct will open without any compression. If compression is advised, do it this way:
  • The lacrimal sac is in the inner corner of the lower eyelid. This sac can be compressed to empty it of old fluids.
  • A cotton swab works much better than a finger. Reason: the swab is smaller.
  • Start at the inner corner of the eye and press upward. Be very gentle.
  • Do no more than once a day.
  • Fluid and mucus may come out of the lacrimal sac.

What to Expect:

  • Over 90% of tear ducts open up on their own.
  • This should happen by the time the child is 12 months of age.
  • If your child is over 12 months old, talk to your child's doctor. Your child may need to see an eye doctor.

Call Your Doctor If:

  • Eye looks infected
  • Eyelid becomes red or swollen
  • You think your child needs to be seen
  • Your child becomes worse

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Photos

Eye Anatomy

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Source: Self Care Decisions, LLC 2023
Self Care Decisions, LLC 2023

Barton Schmitt MD, FAAP
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
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