Pediatric Ophthalmology Consultants

Nasolacrimal Duct Obstruction

Abnormal or overflow tearing is a common condition in infants and babies. In fact, approximately one-third of all newborns have excessive tears and mucus. It is also common for babies’ eyelashes to stick together after sleep, a situation that can cause the eye(s) to become chronically infected.

How do tears drain from the eye?

Tears are necessary to lubricate the eyes. They drain from each eye through two small openings called upper and lower punctum, located along the upper and lower eyelids near the nose. They then flow through the canaliculus into the lacrimal sac located under the skin on each side of the nose. From the sac, the tears are pumped by the blinking action of the lids into the tear duct. These ducts go through the side bones of the nose and empty the tears into the back of the nose. That’s why your nose may run when you cry.

What causes overflow tearing?

Overflow tearing in children is usually caused by the presence of a persistent membrane that blocks the lower end of the tear duct near the nose. Normally this membrane stretches or pops open before birth. In many infants, however, it remains closed, clogging the tear drainage system. The blockage may open spontaneously in a few months as the infant grows.

Are there other causes of tearing?

Very rarely, tearing can be caused by congenital glaucoma. There are other signs and symptoms associated with congenital glaucoma, a serious condition, such as an enlarged eye, a clouded cornea, high pressure in the eye, light sensitivity, and irritability. Tearing can also be caused by wind, pollen, smoke, or other eye irritation.

How is overflow tearing treated?

Initially, your doctor may recommend antibiotic eye drops or ointment used once or twice daily, along with pressure (or massage)


Credits: Journal of American Association for Pediatric Ophthalmology and Strabismus


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