Babies shed a lot of tears. After all, crying is one of their primary forms of communication. But some babies spill many more tears—even when they’re perfectly happy—due to blocked tear ducts.
Approximately 5 percent of all newborns have symptoms of tear duct obstruction, says Dr. Steven Goodrich, a pediatric ophthalmologist with Mercy Children’s Hospital. Those symptoms, including excessive tearing and crusting of the eyelids or lashes upon waking, usually occur within the first few months of infancy.
“Eyelid hygiene of cleaning excessive mattering helps eliminate eyelid inflammation, and massage of lacrimal sac (a small sack at the side of the nose and beside the eye where tears may pool) may help helpful,” Goodrich says.
In most cases, the baby is born with a duct too narrow to properly drain the tears that are produced to keep the eyes moist at all times, and the tears exit the eye externally instead of through the duct and into the back of the nose. Many infants with this problem outgrow it before their first birthday, but those who continue to have symptoms at 9 to 12 months are candidates for a very simple and effective treatment.
“If symptoms persist by 9 months of age, there’s no benefit to waiting longer to treat the problem,” says Dr. Oscar Cruz, an ophthalmologist on staff at SSM Cardinal Glennon Children’s Medical Center. “The success rate (of treatment) is better if you do it before 15 to 18 months of age.”
Cruz is referring to a minor outpatient procedure performed under anesthesia to prevent the infant from squirming. Using a thin, blunt wire, the ophthalmologist gently probes the tear duct to clear any obstruction. Saline irrigation is generally used to ensure the duct is draining properly following the probe. There is little or no discomfort for the baby after the procedure, which only takes about 10 minutes to perform.
“That’s the standard of care. It’s a very common procedure, and the risks are minimal. The only real risk is if the probing doesn’t work,” Cruz says. “If the simple probing fails, you go to a stent.” This involves placing a tiny silicone tube in the duct for six weeks to three months to help stretch the duct and prevent further obstruction.
Both Cruz and Goodrich stress that tear duct obstruction is not uncommon and poses no long-term risks to vision or eye health. “It’s a nuisance more than anything else,” Cruz notes. “It looks ugly, but it’s not anything that will cause a real medical problem.”