In infants, tear production begins within the first 2 weeks of life. If there is a blockage in the tear drainage system, parents will notice that their child has watery eyes on the affected side. In some cases, secondary infections may occur, causing mucus mixed with pus in the eye discharge. Therefore, parents should not be complacent if they observe these abnormalities.
What is Tear Duct Obstruction?
Generally, tears are continuously produced by the lacrimal glands and spread to cover the outer surface of the eye. They then drain through the tear drainage openings located at the inner corner of the eye, both upper and lower. The tears flow through the tear ducts into the nose and then down the throat sequentially. However, if there is a blockage in the tear drainage system, it can cause tears to overflow around the eyes.
What Causes Tear Duct Obstruction in Children?
In infants, the cause is a membrane covering the tear duct opening where it connects to the nose. Usually, this membrane dissolves on its own when the infant is 4 to 6 weeks old. If the membrane does not dissolve in time, it will eventually cause excessive tearing.
Treatment of Tear Duct Obstruction in Children
The effective treatment is massaging the inner corner of the eye combined with antibiotic eye drops. Hands should be washed thoroughly before massaging. Use the dominant finger to press on the inner corner of the eye, directing the pressure toward the bridge of the nose and downward. Massage 10 to 20 times per session, 2 to 3 sessions per day. The pressure should be moderate. The best time to massage is while the child is feeding, as the pressure helps to open the membrane blocking the duct. Over 90% of cases respond well to massage and antibiotic drops, especially in children under 1 year old. If massage is ineffective, particularly in children older than 1 year and 6 months, probing to open the tear duct is recommended.
Care for Your Child After Tear Duct Probing
- Administer medication as prescribed by the doctor.
- Some cases may require continued massage of the inner eye corner to prevent re-blockage.
Risks That May Occur from Tear Duct Probing
- Possible bleeding
- If probing is unsuccessful, treatment may require insertion of a drainage tube.
Benefits of Tear Duct Opening
- Children recover from watery eyes
- Prevents chronic eyelid inflammation
Although tear duct obstruction in children is commonly seen after 2 weeks of age, other conditions can also cause excessive tearing, such as conjunctivitis, foreign bodies in the eye, and pediatric glaucoma. Therefore, children should be continuously examined and treated by an ophthalmologist.
