Tear Duct - Blocked

Pediatric HouseCalls Online

DEFINITION

• Questions about a blockedtear duct previously diagnosed by a physician

Symptoms

• A continuously watery eye (excessive tearing)
• Tears fill the eye and occasionally run down the face, even without crying
• Both sides are blocked in 30% of children
• The eye is not red and the eyelid is not swollen (unless the soggy tissues become infected)

Cause

• Caused by blockage of the channel (lacrimal duct) that normally carries tears from the eye to the nose.
• Present at birth but onset of excessive tearing can be delayed until 1 or 2 months old when tear production increases.

WHEN TO CALL YOUR DOCTOR

Call Your Doctor Now (night or day) If

• Your child looks or acts very sick.
• Eyelid is very red or very swollen.
• Red lump at inner corner of eyelid.
• Cloudy cornea.

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

• You think your child needs to be seen.
• Pus in the eye.
• Eyelid is red or swollen.

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns.
• Diagnosis has never been confirmed by a physician.
• Age over 12 months old.

Parent Care at Home If

• Previously diagnosed blocked tear duct and you don't think your child needs to be seen.

HOME CARE ADVICE FOR BLOCKED TEAR DUCT

1. Reassurance: A blocked tear duct is a common condition that affects 6% of newborns. Both sides are blocked 30% of the time. A blocked tear duct requires no treatment unless it becomes infected.
2. Pus in the Eye : 
   • Lots of pus in the eye (EXCEPTION: only in corner of the eye) means a secondary infection has occurred.
   • This is common with blocked tear ducts and should clear up in a few days with antibiotic eyedrops or ointment.
   • Call or see your child's physician for a prescription. In the meantime, do the following:
3. Remove Pus: Remove the dried and liquid pus from the eyelids with warm water and wet cotton balls several times per day. Once you have antibiotic eyedrops, they will not work unless the pus is removed each time before they are put in.
4. Massage :
   • Some physicians recommend routine massage of the lacrimal sac (where tears collect) twice a day, others do not.
   • The lacrimal sac is in the inner lower corner of the eye. This sac can be massaged to empty it of old fluids and to check for early infection.  
   • A cotton swab works better than a finger.
   • Start at the inner corner of the eye and press upward. Be very gentle.
   • Clear fluid should come out of the corner of the eye.
5. Expected Course: Over 90% of tear ducts open up spontaneously by the time the child is 12 months of age.
6. Call Your Doctor If:
   • Eye becomes infected

   • Eyelid becomes red or swollen

   • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

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