Diseases and Conditions › Pediatric Ophthalmology › Congenital Nasolacrimal Duct Obstruction

Congenital Nasolacrimal Duct Obstruction

Sasha Mansukhani

(MS – Ophthal) Speciality Medical Officer, Kamathipura Eye Hospital, Mumbai
Last Updated: 01/02/2015

Watering from the eyes in babies is most commonly due to a tear drainage duct that is not properly developed. The tears are formed in the tear gland. These tears keep the eyes moist and are normally drained by a duct that runs from the inner part of the eye right to the nose. In some babies, the tube is not well-formed at birth and may be blocked. This causes watering.

However, watering can have many causes, including some vision-threatening causes like glaucoma. Your doctor can help you learn the cause of watering, after a complete examination.

Will the watering stop?

The watering is most commonly due to a tear drainage duct that is not fully formed. In most babies, the tear duct will open out on its own with time. To help in the opening of the duct, a massage can be done regularly. Your doctor can demonstrate the technique of massage to you.

If the watering does not stop, then a small surgery can be done to open out the tear drainage duct.

When should I visit the doctor?

Regular check-ups are required for proper eye examination including tests to evaluate for a spectacle number, as they are found to be more common in babies with blocked tear ducts.

If the skin near the eye becomes red, warm, and swollen then there could be an infection of the tear sac and it is necessary to see your doctor immediately.

How should I massage the tear sac?

Massaging of the tear sac can help in the opening out of the blocked drainage duct.

First, the parent’s hands should be washed and clean. The nail of the index or little finger should be well clipped so as not to hurt the baby. The finger is placed as shown in the picture and pressure is applied in a top-to-bottom direction. This allows the collected tears to drain into the nose, opening out the block. This is repeated for 5-10 strokes, 2-4 times in a day. A little bit of Vaseline or Baby oil can be used in the finger if the baby’s skin gets red due to the rubbing.

congenital-nasolacrimal-duct-obstruction

What surgery is required for watering of the eye?

If the eye continues to water despite the massage and even after 1 year of age, surgery can be done to open out the blocked tube.

A metal probe is inserted from the ‘eye end’ of the tube till the ‘nose end’ in order to open out the blockage. Sometimes a silicone tubing may additionally be put in the duct, to ensure that the duct remains open. If the silicon tubing has been put, it will be removed after 3 to 4 months.

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