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What is Tear Duct Obstruction and Watery Eyes in Infants and Children?

İzmir Kaşkaloğlu Göz Hastanesi

Tear Duct Obstruction in Infants and Children: Symptoms, Treatment, and Probing Procedure

What is Tear Duct Obstruction?
Tear duct obstruction, commonly seen in infants and children, is a condition that prevents tears from draining properly into the nose. This condition typically presents with symptoms such as excessive tearing, discharge, and eyelids sticking together.

At Kaşkaloğlu Eye Hospital, tear duct obstruction in infants is successfully treated with a probing procedure performed under general anesthesia, involving both an ophthalmologist and an ENT specialist.

What is Tear Duct Obstruction?

Tears drain through two small openings located near the inner corners of the eyelids into the tear sac. From there, they are pumped into the nose by the blinking motion. However, in some infants, the membrane covering the passage from the tear sac to the nose does not open at birth, leading to tear duct obstruction.

Symptoms of Tear Duct Obstruction:

Persistent tearing in the eye
Discharge and pus-like secretion
Eyelids sticking together in the morning
Redness and swelling around the eye

These symptoms usually resolve by the time the baby is six months old. However, if they persist, probing of the tear duct may be required.

Causes of Tear Duct Obstruction

The most common cause of tear duct obstruction in infants is an unopened membrane at birth. However, other factors can also lead to blockage or excessive tearing, including:

Exposure to wind, smoke, or chemicals
Foreign objects
Congenital glaucoma (increased eye pressure at birth)

If excessive tearing is accompanied by enlarged pupils, light sensitivity, or corneal clouding, congenital glaucoma should be considered.

Treatment for Tear Duct Obstruction

Treatment depends on the baby’s age and the severity of the obstruction.

1. First-Line Treatment: Massage and Eye Drops

Antibiotic eye drops are used to prevent infections.
Lacrimal sac massage is recommended. This involves applying pressure towards the nose bridge, and your eye doctor will guide you on how to perform it.

Note: In most cases, tearing resolves before the baby turns six months old with massage therapy. However, if the symptoms persist, a probing procedure may be necessary.

2. When Should Probing Be Performed?

Probing is recommended before the baby turns one year old. As the baby grows, the bones harden, making it more difficult to open the duct. Therefore, early intervention is crucial.

How is the Probing Procedure Done?

The baby is placed under mild general anesthesia.
A very fine, blunt metal probe is inserted into the tear duct.
The duct is then flushed with a solution to ensure it is open.
An endoscopic device is used to monitor the nasal passage, increasing the procedure’s success rate.

When performed at the right time, the success rate of the probing procedure is over 90%.

What Happens If Probing Fails?

In some cases, the procedure may need to be repeated. If multiple attempts fail, a surgical intervention (Dacryocystorhinostomy – DCR) may be required at a later age to create a new drainage pathway for tears.

Difference Between Tear Duct Obstruction and Conjunctivitis

Tear duct obstruction in infants is often mistaken for conjunctivitis because both conditions cause discharge and excessive tearing. However, conjunctivitis results from inflammation of the conjunctiva, usually due to an infection or allergy.

Symptoms of Conjunctivitis:

Redness in the eyes
Heavy, pus-like discharge
Sensitivity to light

Treatment for conjunctivitis involves the use of doctor-prescribed eye drops, which typically resolve the condition quickly.

Tear Duct Obstruction Treatment at Kaşkaloğlu Eye Hospital

At Kaşkaloğlu Eye Hospital in İzmir, tear duct obstruction in infants and children is treated by expert doctors using an endoscopic-guided probing procedure under general anesthesia. This method improves the success rate and ensures a more comfortable treatment experience for your baby.