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blocked tear ducts in babies

Blocked tear ducts in babies: Why is there yellow discharge in my baby’s eye?

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There is a lovely nursery rhyme: “two little eyes to look around, two little ears to hear each sound, one little nose to smell what’s sweet…” But when those little eyes are filled with a yellow discharge and the eyelashes are glued closed, parents don’t find it lovely at all. In fact, it generally makes parents very worried.

There are various reasons for eyes to have a discharge, the most common of which is a blocked tear duct (nasolacrimal duct obstruction).

Why do newborn babies get blocked tear ducts?

The American Academy of Ophthalmology reports that almost 20% of babies have a blocked tear duct. This means that it is common and may affect your little treasure.

This condition may occur because the end of the tear duct doesn’t open properly. Other babies may be born with narrow ducts and these may be blocked with mucus or cells that were there even before the baby was born. A blocked tear duct may occur in one or both eyes.

Tears only form in the eyes two to three weeks after birth. Tears have the job of cleaning the eyes and keeping them moist. When your baby blinks, the eyelids sweep the tears into the ducts, which then drain into the nose. If the little ducts, in the corner of the eyes, are blocked, then the tears are pushed back into the eyes instead of draining into the nose. The block leads to watery eyes and a sticky discharge may form in the corner of the eyes.

Depending on the cause of the blocked duct, a baby may show symptoms any time between birth and 12 weeks of age and the condition may last up to 12 months.

How do I know if my baby has a blocked tear duct?

The signs and symptoms to watch out for in a baby that might indicate that they have a blocked tear duct include:

  • Yellowish discharge in the eyes
  • Eyelids stuck together
  • Watery eyes
  • Mild irritation of the eyes
  • Often only affects one eye (an infection would most likely occur in both eyes)
  • Occurs in the first few weeks after birth

What should I do if I suspect my baby has a blocked tear duct?

Keep the eyes clean:

Flush the eye with breast milk, if you are breastfeeding. You can also use normal saline or boiled water that has been cooled to room temperature. Use a piece of gauze or cotton wool to gently wipe the discharge away. Wipe the eye from the corner closest to the nose, out towards the ear. Apply gentle pressure to help unclog the duct.  Throw away the cotton wool or gauze after each wipe.

Tear duct massage:

Make sure you have washed your hands well. Make sure your fingernails are short. You may use your pinkie finger to gently massage against the side of your child’s nose, next to the affected eye. Press gently and move your finger in short downward strokes 3 to 5 times. Repeat these 3 to 4 times a day. If you are unsure of how to do this, you can ask your healthcare professional to demonstrate it for you or check out a video on the technique.

If the eye gets progressively worse and does not respond to the measures mentioned above then you should seek help from your healthcare provider. After a year of age, an ophthalmologist may need to open the duct with a little probe.

Other causes of eye discharge in babies

Conjunctivitis

Viral eye infections are not common in the newborn phase (first 2 months) but a blocked tear duct may lead to an infection such as bacterial conjunctivitis. Your baby may experience symptoms such as swelling, tenderness and redness of the eye area. The white of the eyes often turns pink or red. The eyelid itself may swell and the eye discharge is significant. The infection may begin in one eye and then spread to the other eye. Your healthcare provider will most likely take a swab of the puss in the eye to determine the best course of treatment. In most cases, conjunctivitis is treated with an antibiotic drop or ointment. In very severe cases an oral antibiotic may be necessary.

Chemical conjunctivitis

As with any treatment, a baby may react to the drops or ointment given to treat the infection. Your baby’s eyes may become irritated and develop redness and puffy eyelids. Discuss this with your healthcare provider to find an alternative treatment.

Ophthalmia Neonatorum

This is a rare bacterial infection of the eyes which may occur if a baby passes through the birth canal infected with chlamydia. The baby would usually develop symptoms 5 to 12 days after birth. These symptoms would typically include pus, red angry eyes and swollen eyelids. These babies would often have the infection in other parts of their bodies as well.

Conclusion

Sticky eyes caused by blocked tear ducts are really common. 90% of cases heal all by themselves. Since eyes are so precious, one should not ignore signs of an infection. Your healthcare provider will guide you regarding a diagnosis of a blocked tear duct (nasolacrimal duct obstruction) or any other cause for gooey eyes. Simple cleaning and massage are likely to be the only intervention but in cases where the infection is present, it is best to have the proper treatment.

References

  1. https://aapos.org/glossary/nasolacrimal-duct-obstruction
  2. https://www.aao.org/eye-health/diseases/what-is-blocked-tear-duct
  3. https://raisingchildren.net.au/guides/a-z-health-reference/blocked-tear-duct
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313586/.
  5. https://www.mayoclinic.org/diseases-conditions/blocked-tear-duct/symptoms-causes/syc-20351369
  6. https://www.ncbi.nlm.nih.gov/books/NBK532873/

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