A few days after we brought our son home from the hospital, he woke up with one of his eyes crusted shut with green gunk.
I was horrified by my sweet baby boy's perfect face being marred, and immediately called our family eye doctor. Visions of pink eye and house-wide infection popped through my head. What could it be? Would he be OK? Would he go blind?
Luckily, our eye doctor eased my worries right away and assured me that it wasn't a life-threatening eye infection, but actually just a blocked tear duct.
What is a blocked tear duct in babies?
Blocked tear ducts, also called nasolacrimal duct obstruction, are relatively common in newborn babies. Around 5-10 percent of babies will have a blocked duct, sometimes in both eyes. One of the most common causes of a blocked tear duct is that the membrane that covers the end of the duct doesn't open like it should. Without the membrane opening, the duct literally gets "blocked" with the tissue of the membrane.
A blocked tear duct could also be caused by:
- absence of the opening of the duct of the upper or lower eyelid
- a tear duct system that is too narrow
- an infection
- a crooked or misplaced bone blocking the tear duct from the nasal cavity
Blocked tear ducts can also be worsened by other symptoms, like if your baby has a cold.
What are the symptoms of a blocked tear duct?
Like we experienced with our baby, the symptoms of a blocked tear duct can look a lot like an eye infection such as pink eye. The signs of a blocked tear duct usually begin during the first few days or weeks of a newborn's life. Symptoms might include:
- constant tears
- mildly swollen and red eyelids (the eyes themselves should not be red)
- eyelids that stick together
- green-yellow discharge
In most cases, the discharge, even though it looks gross and scary, is actually just tears along with normal bacteria, and not a sign of infection. All of us, babies included, have normal bacteria on our eyelids that get flushed away by our tears, so when the duct system is clogged, the bacteria has nowhere to go and just kind of hangs out on the eyelid.
Sometimes, however, an infection can develop, so you'll want to watch your baby for any signs that the discharge, redness, or swelling is getting worse. Make sure to have your doctor check your baby before you assume that it is just a blocked tear duct, as an infection can be serious.
How do you treat blocked tear ducts in babies?
Luckily, in most cases, blocked tear ducts aren't really any big deal. The American Association for Pediatric Ophthalmology and Strabismus explains that in the majority of cases, the blocked tear ducts actually clear up completely on their own without any treatment at all.
In the meantime, there are a few simple ways to help clear up blocked tear ducts at home.
Use a warm compress
Every few hours, when the drainage builds up, warm up a clean and soft washcloth or cotton ball with water and gently clean the eye. You can apply gentle pressure to the tear duct and wipe from the inside of the duct to the outside, so you don't wipe anything into the eye.
If both of your baby's eyes are clogged, use a different, clean side of the washcloth or new cotton ball before wiping the other eye.
Apply tear duct massage
To help open the tear duct and empty it out, ask a doctor to demonstrate how to do tear duct massage. Essentially, you can apply gentle pressure between the ducts, alongside of the upper nose to try to help them clear.
You can perform the duct massage up to two times a day, but remember that it's very important to be as gentle as possible.
If the ducts do get infected, your child's pediatrician or eye doctor might prescribe antibiotic drops or ointment to put into the eyes to clear up the infection.
Most cases of clogged tear ducts will resolve as your baby gets older. They will typically go away completely by 12 months of age, especially with at-home treatments. But if your baby continues to have clogged tear ducts past 1 year of age, your doctor may recommend a simple procedure to help unclog the tear ducts.
Can you prevent blocked tear ducts?
In newborns, many times the blocked ducts is a result of the membrane not opening at birth, so there's not really a good way to prevent that from happening.
But you can monitor your baby once they are born. Of course, be sure to never smoke around your baby or allow smoking in your house. Smoke, aside from other dangerous health hazards, can irritate your baby's nasal passages and make the blockage worse.
If you notice that your newborn has "gunk" in their eyes, don't panic. If your baby is otherwise well, it's probably just a clogged tear duct, which is fairly common in babies. Have your doctor check your baby to make sure. Watch your baby for signs of an infection and report any symptoms to your doctor. Call your doctor immediately if you baby seems ill or has a fever.
You can also try some at-home remedies, like massage or a warm washcloth, to clear the eyes and help relieve your baby's discomfort.