Photo by Karin Pedersen Photography

Blocked tear ducts are a relatively common occurrence in newborn babies.  It is one of the most common reasons for a baby to have persistent tearing and discharge from the eyes.  One study found that up to 20% of babies will have problems with tear drainage in the first year of life.  

Causes of Blocked Tear Ducts

The most common reason for a baby to have blocked tear ducts is due to a congenital nasolacrimal duct obstruction.  This means that at birth, the tear duct system is incomplete, and tears do not drain properly.  Tears have nowhere to go so your baby often has watery eyes and sometimes discharge. 

The good news is that blocked tear ducts usually resolve spontaneously before 6 months of age.  

Symptoms

The most common symptom is persistent watery eyes.  Sometimes the tearing is intermittent, worsening when in an environment that increases tearing, such as being in the wind or cold weather.  

Sometimes the lower eyelid can get irritated if your baby is rubbing their eyes often.  

The whites of the eyes should not be red.  If the eyes are reddened, this could indicate conjunctivitis instead.  

There should be no pain or discomfort with a blocked tear duct.  

Nasolacrimal Massage

The first line management of blocked tear ducts is nasolacrimal massage or compression.  

Instructions for performing nasolacrimal massage:

  1. Wash your hands, keep your fingernails cut short
  2. Using your index finger, apply moderate pressure to the corner of the lower eyelid and slide your finger downward along the nose maintaining that pressure
  3. Repeat two to three times a day

This helps to unblock the tear duct and allow the tears to drain naturally.  

Other Management Strategies

It is important to keep the eye clean.  Wash the eyelids and the face regularly with a clean facecloth.  

In some cases, blocked tear ducts can get infected and antibiotics maybe required. Signs of infection may include pain, redness, swelling or puss.  Please contact your health care provider if the blocked tear duct does not resolve, signs of infection or if you are concerned.  

 
This post was co-authored by Erin Manchuk, BScPharm, BCGP and Stephanie Liu, MD, MSc, CCFP, BHSc.