Helping a Newborn With a Blocked Tear Duct
Blocked tear ducts are a common complaint of parents about their newborn babies. They present to the pediatrician with a child who appears to have tears spilling over onto their cheeks without evidence of crying. The child may also have mucus type material on the edges of the eyelid.
Parents are often concerned that their newborn has contracted pink eye before even being exposed to others.
Normally tears are cleared from the eye through the tear ducts. However, when those ducts are blocked the tears flow down the cheek or build up and dry out leaving clumps of yellow discharge in the eye. The nasolacrimal duct (tear duct) takes the tears and passes them through to the nasal cavity.
When infants have a blocked tear duct it doesn’t mean that they don’t make tears or that they make too much but rather that the duct that removes the tears from the eye is obstructed or closed and the eye becomes flooded.
This condition happens to approximately 20% of newborns. It can affect either one or both eyes. Sometimes these blocked ducts arent immediately evident at birth and aren’t noticed until the baby is a month old. Blocked ducts often open up themselves within the first few weeks or months of life.
Normally tears are produced by the lacrimal gland that is located just over the eye. They move across the eye with the help of the eye lid and they keep the eyes lubricated and moist as well as protected. Sometimes the nasolacrimal ducts aren’t completely open at the time of birth which is what causes the obstruction.
Treatment for newborn blocked tear ducts are mostly a wait and see treatment. Most of these conditions resolve by the time the child has reached 10 months of age as their body grows. The blockage appears to be most often caused by a membrane that remains over the tear duct from birth and which opens as the baby grows.
Sometimes professionals advise the parents to massage the area over the tear duct to help open it enough to accept most of the tears that are produced and thereby decrease the symptoms. This massage is thought to help break this membrane over the duct but if there isnt a build up of tears or the lacrimal gland isn’t swollen then this massage probably isn’t necessary.
If this condition has resolved with massage then a probing with a metal instrument under general anesthesia to break the membrane may be necessary and cures about 90% of those who don’t resolve spontaneously. In the rare instance that this doesn’t resolve with the probing then another surgical placement of a balloon to stretch the duct or the creation of a new passage may be necessary.
There are those instances when a blocked tear duct occurs in older children or adults who experience an infection of the tear duct or a nose injury or sinus infection can cause scarring of the nasolacrimal duct and obstruction.
Infants and older children who experience a blocked tear duct should have their eyes and face kept clean so they dont have an area that is set up for an infection. This increased amount of mucus type material residing in the eye is a breeding ground for infection. Keeping it clean while the eye is being treated and cared for will help to decrease the risk of a secondary infection.
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