Blocked tear ducts in babies

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 that my sweet baby boy’s perfect face was marred, and immediately called our family eye doctor. Visions of pink eye and house-wide infection went 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 a blocked tear duct.

Luckily, in most cases, blocked tear ducts aren’t serious. The American Association for Pediatric Ophthalmology and Strabismus (AAPOS) explains that in most cases, blocked tear ducts clear up on their own without treatment.

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. Then, wipe from the inside of the duct to the outside so you don’t wipe anything into the eye. The duct is located between the lower eyelid and the nose, and the main opening is on the part of the lower eyelid closest to the nose.

If both of your baby’s tear ducts are clogged, use the clean side of the washcloth or a new cotton ball before wiping the other eye.

Apply tear duct massage

To help open the tear duct and empty it out, you could do a tear duct massage. Essentially, you can apply gentle pressure toward the opening of the duct, alongside the upper nose and along the lower eyelid, to try to help them clear. Ask a doctor to demonstrate how to do this.

You can perform the duct massage up to two times a day. But remember, it’s very important to be as gentle as possible.

Eye drops

If the ducts do get infected, your child’s pediatrician or eye doctor might prescribe antibiotic drops or ointment to put into the eyes. The drops or ointment will clear up the infection.

Most cases of clogged tear ducts will resolve as your baby gets older — typically by 12 months of age, especially with at-home treatments.

But, if your baby has clogged tear ducts past 1 year of age, your doctor may recommend a simple procedure to help unclog the tear ducts.

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 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. This causes the duct to become blocked by the tissue of the membrane.

A blocked tear duct could also be caused by:

  • the 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

Other symptoms caused by conditions like a cold can worsen symptoms of a blocked tear duct.

What are the symptoms of a blocked tear duct?

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 should not be red)
  • eyelids that stick together
  • green-yellow discharge

In most cases, the discharge is actually tears and normal bacteria, and not a sign of infection. The discharge produced by a blocked tear duct will appear similar to the discharge from an infection, but the eye itself will only become red with an infection.

All of us, babies included, have normal bacteria on our eyelids that get flushed away by our tears.

When the duct system is clogged, the bacteria has nowhere to go and stays on the eyelid. This could cause an infection to develop. You’ll want to watch your baby for any symptoms that the discharge, redness, or swelling is getting worse.

Make sure to have your doctor check your baby for a blocked tear duct. If an infection is causing the symptoms it can be serious.

Can you prevent blocked tear ducts?

In newborns, many times the blocked ducts result from the membrane not opening at birth. There’s no good way to prevent this from happening.

However, you can monitor your baby for symptoms. Be sure to never smoke around your baby or allow smoking in your house. Smoke, and other potential hazards like dry air, can irritate your baby’s nasal passages and make the symptoms of the blockage worse.

The takeaway

If you notice that your newborn has “gunk” in their eyes, don’t panic. If your baby is otherwise OK, it’s probably just a clogged tear duct, which is common in babies.

Have your doctor check your baby to make sure. Watch your baby for symptoms of infection and report them to your doctor. Call your doctor immediately if your 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.