Blocked Tear Ducts
Tears drain from the eyes through a duct that runs from the inner eye into the nose on each side. Newborns and young infants have narrow tear ducts that commonly get clogged. When the ducts are clogged, the tears don’t drain well and back up into the eyes. This creates excessive tearing. When the tears dry out, they get thicker, and this may cause matting of the lids as noted in the above picture.
How is it treated? Blocked tear ducts can often be helped along by tear duct massage. The ducts start from the inside corner of the eye, head straight down the side of the nose where they enter the nose midway down. Tear duct massage involves placing one’s finger at the inner corner of the nose, and massaging gently straight down parallel to the nose. You can do this periodically throughout the day to help the tears drain. As the matting accumulates, gently wipe it away with a warm, soft, moist washcloth. Remember to be gentle as the lids are sensitive.
What to watch for? The main thing to monitor for is making sure that no infection is present. There are a few types of infection to watch for:
- Superficial infection of the stagnant tears is a common complication of a blocked tear duct. Typically the discharge becomes significantly more thick and pus-like than usual, and there may be increased redness. Antibiotic drops in the eye will usually treat this infection. Call the office for a prescription or an appointment (not urgent during the night, but should be addressed within 24 hours).
- Conjunctivitis, otherwise known as pink eye, is when the whites of the eyes actually turn red/bloodshot. This is not a normal part of blocked tear ducts — it indicates an infection is present and this requires medical attention. Sometimes we can call in treatment for you, see conjunctivitis page for more details.
- Periorbital cellulitis is a deeper infection of the skin surrounding the eye. You can tell it apart by a significant rim of redness circling or spreading out from the eye. This infection is uncommon, but is much more serious and requires urgent medical attention. If it is during our office hours, call us for an urgent appointment, otherwise take your child in to an urgent care or ER. Again, see conjunctivitis page for photo and more details.
- Dacryocystitis is an infection of the tear duct itself that is an uncommon complication of a blocked tear duct in children. The nasolacrimal sac (a small sac in the tear collecting system located between the eye and the nose) may become enlarged and swollen from the infection, and this requires urgent attention.
What is the natural course of a blocked duct? Blocked ducts tend to come and go throughout the first year of life. They will often flare up periodically during upper respiratory infections/common colds. About 90% of blocked ducts resolve for good at some point within the first year of life. If it hasn’t resolved by 9-12 months of age, it may need to be repaired by an ophthalmologist. This is a simple procedure where they probe the duct with a small blunt wire that removes the blockage, but it does require sedation.
For urgent needs, same-day appointments are available Monday through Friday. Please call as early in the day as possible, the more notice we have the easier it is to fit everyone in.
Need help outside of office hours?
Firstly, if your child has an emergency, please call 911 or go directly to the ER - they will contact us if needed once your child has been evaluated.
Urgent Care centers can also be helpful when something needs to be seen outside of office hours but it's not an emergency.
For our list of preferred Urgent Cares and ERs, see our resources page.
And if you have something that might need urgent attention but you're not sure/don't know what to do, we can help: