Tears without sobs – there’s a problem

The trickling down of tears is one of the many forms of expression in human beings. There are tears of joy and tears of pain. However, for newborns, though they cry, they do not have the capacity to produce tears, at least not until the end of the first month. It is around this time that some babies develop a blocked tear duct, which is a blockage of the passage way that carries tears from the eyes to the nose.

Statistics show that up to 30 per cent of newborns world wide are born with a blocked tear duct. It is characterized by a constantly teary eye with tears spilling over even when the infant is not crying. Most of the time, the eye is not red or swollen.

The blocked tear duct may clear up by the end of the first year. However, your doctor may recommend massaging the inner corner of the eye, to unblock it faster. Remember, a red or swollen eye is a sign of infection and should be treated by a doctor immediately.

Symptoms of a blocked tear duct

Teary eyes or moist eyes which produce a lot of tears that drain onto the child’s cheeks.

Eyes that appear crusted and matted with discharge, because mucous material backs up onto the eye.
Reddening of the eye if your child continually rubs it.

Treatment

Fortunately, most cases of blocked tear ducts go away on their own. However, if your child’s condition does not go away, treatment may include:

Massaging the inside corner of your child’s nose 2 to 3 times a day

Cleaning any discharge or matter in the eyes with a warm washcloth. Antibiotic eye drops when the discharge in the eyes becomes excessive, like if you are having to wipe it away more than two or three times a day.

Oral antibiotics may be prescribed by a doctor if your child develops symptoms of dacryocystitis—inflammation of the lining of the tear sac near the inner corner of the eye.

If your child’s blocked tear duct does not go away on its own, especially by the time he is 9 to 12 months old,  additional treatment by probing the nasolacrimal duct (which connects the nose and the tear-producing sacs) may be necessary. In this procedure, a paediatric ophthalmologist (a medical doctor specialising in the diagnosis and treatment of diseases of the eye) will insert a probe into the nasolacrimal duct, attempting to clear anything that is blocking the duct.

6 things to note

1 Although children with a complete blockage will always have symptoms, if your child has a partial blockage, you may only notice the symptoms if his nose is blocked, like when he has a cold.

2 If your child’s eyes are tearing and he is fussy and irritable, instead of a blocked tear duct, your child may be evaluated for congenital glaucoma (usually the result of incorrect or incomplete development of the eye’s drainage canals during the prenatal period).

3 If your younger child is repeatedly diagnosed with pinkeye (inflammation of the eye), especially if his eye is not usually red, then he may have a blocked tear duct.

4 Children can have a blocked tear duct affecting either one or both eyes.

5 Probing can be done early, before a child is 6 to 8 months old by a paediatric ophthalmologist, without general anaesthesia. Anaesthesia would be necessary for older children.

6 A paediatric ophthalmologist can be helpful when your child has a blocked tear duct. However, a paediatrician can also manage most simple cases.

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