Blocked Tear Duct (Dacryostenosis) in Children

What is a blocked tear duct in children?

A blocked tear duct is called dacryostenosis. It may also be called a congenital lacrimal duct obstruction. Congenital means that your child is born with it.

Tears help clean and lubricate your child’s eyes. They’re made in the lacrimal gland. This is located under the bone of the eyebrow. Tears from the lacrimal gland go into the eye through tiny ducts along the eyelid. Tears drain through two small openings at the inner corner of the eyelids. They then drain into a larger passage from the eye to the inside of the nose. This is called the tear duct (nasolacrimal duct).

What causes a blocked tear duct in a child?

In some children, the openings into the tear duct don’t form the right way. This causes a blockage. The tears have no place to drain.

A blocked tear duct can happen in one or both eyes. The blockage may be there at all times. Or it may come and go.

What are the symptoms of a blocked tear duct in a child?

Babies don’t make tears until they are several weeks old. So you or your baby’s healthcare provider may not notice a blocked tear duct at birth.

Symptoms can happen a bit differently in each child. They can include:

• Tears pooling in the corner of your child's eye

• Tears draining down your child's eyelid and cheek

• Mucus or yellowish discharge in your child’s eye

• Reddening of the skin around your child’s eye. This is caused by rubbing.

Your child may have symptoms only when they cry. Symptoms may show up only in cold or windy weather, when tears are stimulated.

The symptoms of this health problem may be like symptoms of other conditions. Have your child see their provider for a diagnosis.

How is a blocked tear duct diagnosed in a child?

Your child’s healthcare provider may diagnose a blocked tear duct by giving your child an exam. They will also ask you about your child’s health history. Your child may need more tests to confirm the diagnosis.

How is a blocked tear duct treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

The most common initial treatment for a blocked tear duct is gently milking or massaging the tear duct 2 to 3 times a day. Your child's healthcare provider will show you how to do this. If this isn't effective, other treatments or surgery may be needed.

What are possible complications of a blocked tear duct in a child?

Sometimes a blocked tear duct may cause an eye infection. If this happens, your child may need antibiotics.

Most blocked tear ducts heal on their own. This often happens by the time your child is 1 year old.

If the duct is still blocked after your child is 1 year old, they may need treatment. Your child’s healthcare provider may enlarge the tear duct opening with a small probe. Sometimes this treatment needs to be done again. If this doesn’t work, your child may need surgery to fix the duct.

Key points about a blocked tear duct in children

• In some children, the openings into the tear duct don’t form the right way. This causes a blockage. The tears have no place to drain.

• Babies don’t make tears until they are a few weeks old. Most blocked tear ducts aren’t noticed at birth.

• A blocked tear duct may be noticed only when a child cries. It may also show up in cold or windy weather, when tears are stimulated.

• The most common treatment is gently milking or massaging the tear duct 2 to 3 times per day. In some cases, the tear duct needs to be opened using a probe. In more severe cases, your child may need surgery.

• Often, blocked tear ducts heal on their own by the time your child is 1 year old.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are and when to report them.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is advised and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.