TEARING IN INFANTS

Excessive (or overflow) tearing occurs frequently in infants. About one-third of newborns experience overflow tearing and mucus. It is not unusual for babies to wake up with their eyelashes stuck together, leading to chronic eye infections.

Overflow tearing in infants is usually the result of a membrane that blocks the lower end of the tear duct near the nose. Typically, this membrane pops at or before birth; however, in many infants, it remains closed which prevents the tears from draining properly. As the baby grows, this membrane may open on its own. Tearing can also be caused by environmental irritants such as smoke, wind and pollen. Rarely is the tearing caused by congenital glaucoma. This condition is usually associated with high pressure in the eye, light sensitivity, clouding of the cornea (which is normally clear) and an enlarged eye.

Overflow tearing may be treated with antibiotic eye drops or ointment in combination with massage of the tear sac. This is done by placing a finger under the inner corner of the eye next to the nose, and rolling the finger over the bony ridge while pressing down and in against the bony side of the nose. This helps to rid the sac of the tears and mucus. Use of eye drops or ointment should follow massage. Usually, tear duct obstructions are resolved by the time the baby is six months old; however, if not, your doctor may need to clear the blockage by using a probe to go inside the tear duct.

A tear duct probe is done by placing a thin, blunt, long metal device through the drainage system to clear the obstruction. Next, the doctor irrigates fluid through the drainage system to be sure there is no remaining blockage. This is not a painful procedure and, on adults, can be performed in the office. With children, however, it is usually necessary to perform the procedure in the hospital under anesthesia. After the probe, it is normal to have some bloody tears or nasal secretions as well as some discharge from the eye for several days. Antibiotics may be prescribed to use after the procedure. It is possible for the obstruction to recur or for the probing not to work. In this case, a tube can be placed in the drainage system. Should this not resolve the blockage, further surgery may be done to create a new opening through the bone into the nose, thus bypassing the blocked tear duct.

Complications can occur anytime surgery is performed. There is a chance of bleeding or infection, scarring which can re-obstruct the opening and requiring further surgery.