Doctors’ Notes


Blocked Tear Ducts in Infants

The most common cause of watery, crusty eyes in infants is a blocked tear duct, occurring in up to 20 percent of newborns. Some babies may have symptoms right from birth, while others may develop symptoms months later. Blocked tear ducts may affect just one eye or both eyes, and symptoms can be intermittent.

How it Works

Normally, tears are produced by the lacrimal gland and then flow across the eye, keeping it clean and lubricated. When you blink, the eyelids squeeze those tears from your eye into the lacrimal sac in the inner corner of your eye. Those tears then drain out of the sac through a small tube (the nasolacrimal duct) into the back of the nose. This prevents tears from building up in our eyes.

Cool Facts About Tears

1. We actually drink our own tears!
As those tears drain into the back of our nose and throat, we swallow them.

2. When you cry and your nose runs, those are actually tears draining out of your nose!
All those tears come pouring out your eyes, through your nasolacrimal duct, into your nose, and end up being blown out into a tissue. (Or onto your sleeve, if you’re in kindergarten…)

How it Happens

Sometimes those nasolacrimal ducts get blocked, and tears don’t drain properly. This can happen when the duct hasn’t fully developed and opened yet, or if it becomes obstructed.

When an infant has a blocked tear duct, the eyes still make tears normally, but they have trouble draining them away from the eye, so the tears end up collecting in the eye. The eyes end up looking wet, and tears may spill out onto their cheeks even when they’re not crying. Also, the eyes often end up getting crusty and “goopy.” This happens when the tears sit in the eye for a while (like during a nap, or when sleeping at night) and the water part of the tear evaporates, leaving behind that crust you see when you wake up.

What You Can Do

The good news is, most infants typically outgrow this before 12 months of age. We may recommend massages if there is fluid build-up in the lacrimal sac, and we can demonstrate them for you in the office if that happens. Otherwise, massaging the lacrimal sac or nasolacrimal duct typically won’t help much and probably isn’t necessary.

Until infants outgrow it, the best things to do are to keep the eye clean, gently wipe away any crust with a warm, moist washcloth, and be sure to call us if things are getting worse. (You don’t want to be ignoring pink eye and mistaking it for a blocked tear duct!)

Dr. Albert Wolf, a proud Kids Plus Doc since 2000, is a shareholder and Chief Financial Officer of the practice.