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Infant Blocked Tear Duct : Causes, Symptoms, Tests, Treatment, Surgery

Few Facts About Infant Blocked Tear Duct:

  • The eyes of approximately six percent of every newborn have their tear duct blocked.
  • One eye or both eyes can have their tear duct blocked.
  • It is not easy to notice a Blocked Tear Duct at birth since infants produces tears several weeks after birth. Only when tears are stimulated is the time that one can notice this, and it is because this is only when a baby cries, when cold or in a windy condition.
  • Tear ducts usually opens in all the infants when the child attains the age of one year.

What is an Infant Blocked Tear Duct?

Tear ducts are tiny tubes that drains tears stretching from the eye all the way to the nose. Tears will not be draining from the eye if a tear duct is blocked at some instance and fails to unblock. Inflammation, swelling, and sometimes infection will occur due to the fluid filling the duct.

Infant Blocked Tear Duct

This blockage of the tear duct often occurs in infants, but it can also happen in any age. Six in every 100 newborns are affected with infant blocked tear duct.

The blockage does not cause any eye damage to the infant and it is always known to clear when the infant is 1 year old.

The Causes of Infant Blocked Tear Duct

Infant blocked tear duct can be witnessed at infancy and during birth (congenital). The following the causes of infant blocked tear duct:

  • When infants are born having blocked tear duct an abnormality or under development of the tear drainage can be a cause at this time. If a tear duct is congenitally blocked, there will be a thin tissue crust remaining at the opening of the duct; the tissue empties itself down to the nose. This is usually occurs at the second month after birth.
  • The thin tissue which is present at the very end of the tear duct does not open normally. The is the most common cause of infant blocked tear duct.
  • Infections to the infant are one of the causes of infant blocked tear duct.
  • Abnormality with the development of nasal bone, which exerts pressure on the tear duct, and as a result, it closes it.
  • When the gap at the curves of the eye is underdeveloped or closed, also causes infection.
  • This problem may be inherited and thus it can be witnessed amongst family members.

Signs and Symptoms of Infant Blocked Tear Duct

These symptoms may often affect one eye. The signs and symptoms of infant blocked tear duct may include:

  • Plenty of tears. Tears may flow down an infant’s cheek or the eye may be looking wet.
  • The eyelids will sometimes stick together due to the white or yellow accumulation at the corner around the affected eye.
  • The nose or the eye will swell and appear to be red. Dacryocystitis can cause infection of the drainage system of the eye. This situation can escalate to the eyelids in severe cases. Fever and pain can be suffered if severe infection is present. This can result in more swelling and reddening of the eyes and the nose.

It is only a few weeks after birth when the babies with this problem will begin to experience symptoms of an infant blocked tear duct.

A sinus infection or cold can escalate the symptoms of the infections and it makes it worse than it was before.

When is the Doctor’s Attention Needed?

If continuous irritation, infection, or being leaky and watery of the baby’s eye is noticed, it is advisable to see a doctor. Tumors can also press the drainage of the tear, which results in the blockage of the tear duct. Quick discovery of such tumors can guarantees more remedy alternatives.

Tests to Diagnose Infant Blocked Tear Duct

You must be prepared to be examined and take a few tests regarding tear drainage. Any disorders regain the structure of the nasal passage are also going to be taken so as to ascertain if you nose has any abnormality which might be causing the abnormality by obstructing the drainage. Effective treatment will be taken in case of a blockage after confirming the location of the obstruction.

Tests that are taken when diagnosing an infant blocked tear duct are as follows:

  • Tear drainage examination. This is also known as the ‘fluorescein dye disappearance test.’ The test measures how quick your tear drains. A drop of a special dye is introduced differently on each eye. After a few minutes of blinking the eyes, it is expected that the dye disappears and hence, if it takes long before disappearing then the tear duct might be blocked.
  • Probing and Irrigation is another test, which the doctor flushes a saline mixture on the tear drainage to ascertain if it drains as if it is supposed to drain. The doctor can also use a thin instrument called ‘probe’ which is inserted through the slender holes found at the lids’ corners (puncta), in to find any blockage. A narrowed puncta always dilate during the probing process, a procedure that solves the problem.

Treatment Options for Infant Blocked Tear Duct

The treatment for the infant will be determined by the cause of the infant blocked tear duct. Correction of a blocked tear duct can require more than one procedure or treatment in order for it to be fully corrected.

A doctor will always prescribe eye drops if an infection is witnessed.

Blocked tear ducts occasioned from non-tumor causes always differ and it ranges from surgery to simple observation.

Conservative Treatment for Infant Blocked Tear Duct

Majority of babies who are born with infant blocked tear duct always recover without undergoing any treatment. It always happens with the maturing of the tear duct during the first few months after birth. Extra opening up of the membrane in nasolacrimal duct can be associated to this.

You can be shown a massage technique for your baby if the blockage of the tear duct does not improve. After several days of this massage, the membrane blocking tear flow will eventually open up.

Massaging the tear ducts:under the nasal corner of the baby’s eye, the tear ducts lies beneath. A pump is felt on these locations when eyelids meet. Use your fingertips to massage gently in semi-circle manner. This should be approaching the nose inwardly from the eye’s corner. Six times to ten caresses on a daily basis shall yield positive results. Ensure you do this routinely, for instance before you change the diapers. When gentle pressure is applied on the clogged drainage, the fluid in the tear duct will be forced and thus opening it up.

Minimal Invasive Therapy to Treat Infant Blocked Tear Duct

Minimal invasive treatment is administered for babies and infants with blocked tear duct. Adults with narrow puncta or partial blocked duct can also be helped through the same procedure.

  1. Dilation, Irrigation and Probing to Treat Infant Blocked Tear Duct

    Most infant’s whit their tear ducts blocked from birth can be helped through the technique of Dilation, Irrigation and Probing. General anesthesia can be used when administering this procedure in extremely young infants. The opening of the puncta is opened first by the doctor using a dilation instrument. The doctor inserts a slender probe through the baby’s puncta into the drainage system of the tears. The doctor down to the nasal cavity pushes the probe. Popping noise can occasion sometimes when the probe is inserted due to it piercing the extra tissue.

  2. Balloon Catheter Dilation to Treat Infant Blocked Tear Duct

    Balloon catheter dilation is helpful in treating the infant blocked tear duct. Balloon catheter is used to open up any blockage caused by any acquired conditions or inflammation and scarring. General anesthesia is used in this procedure through the dripping of the tube down the nasolacrimal duct inside the infant’s nose.

    Usually a pump is used which inflate and deflate the balloon a couple of times while moving in different sections of the tear duct system. Adults whose drainage system has been blocked partially can use this procedure but it is most preferred to be more effective in toddlers and infants.

Surgery to Treat Infant Blocked Tear Duct

Toddlers and infants who have had no success with the invasive approach can have surgery for infant blocked tear duct.

Dacryocystorhinostomy is the surgical method that is commonly used when treating an infant blocked tear duct. The procedure involves the reconstruction of the drainage, which restore normal tear drain down through the nose back to normal. Local anesthetic is administered first or the general anesthetic if the procedure is performed as an outpatient.

Accessing the tear passageway is the first step the surgeon takes who then creates direct connection, which is new between the nose and lacrimal sac. The (nasolacrimal sac) which is the common site for blockage is bypassed by the new route which empties to the nose. The new route is guided by intubation or stents, during the healing process. They are removed after three months have elapsed after having the surgery.

Prevention of Infant Blocked Tear Duct

Sometimes treatment is not a necessity in the infants having the problem of infant blocked tear duct. In order to ensure the prevention of infection and other issues until infant blocked tear duct is resolved:

  • Always ensure the eye is clean. In order to wipe away the drainage in tear duct, you moisten a cotton wool, which is clean, or a smooth cloth with relatively warm water wiping the area close to the nose toward the outer part of the affected eye.
  • Gently massage the affected area if it is your doctor’s suggestion. This prevents the accumulation of fluids.
  • You should minimize the amount of sunlight, cold, and wind that your infant is exposed to.
  • Ensure to clean your hands prior and after touching the affected area of the eye.


  1. American Academy of Ophthalmology. (2021). Blocked Tear Duct. https://www.aao.org/eye-health/diseases/blocked-tear-duct
  2. University of Michigan Kellogg Eye Center. (2021). Tear Duct Surgery: Dacryocystorhinostomy. https://www.umkelloggeye.org/conditions-treatments/tear-duct-surgery-dacryocystorhinostomy

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 17, 2023

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