05/05/2026
๐๐๐๐ง ๐ฟ๐ช๐๐ฉ ๐๐๐จ๐ฉ๐ง๐ช๐๐ฉ๐๐ค๐ฃ ๐๐ฃ ๐ฝ๐๐๐๐๐จ: ๐๐๐๐ฉ ๐๐๐ง๐๐ฃ๐ฉ๐จ ๐๐๐๐ ๐ฉ๐ค ๐๐ฃ๐ค๐ฌ
Tear duct obstruction, also known as congenital nasolacrimal duct obstruction (CNLDO), is a common condition in babies, affecting approximately 5โ20% of newborns. It occurs when the tear drainage system, which normally carries tears from the eye into the nose, is blocked or has not fully opened at birth.
What Causes It?
In most cases, the blockage occurs because a thin membrane at the lower end of the tear duct (near the nose) fails to open completely after birth. Less commonly, the obstruction may be due to narrowing of the duct or abnormal development of the drainage system.
Signs and Symptoms
Parents usually notice symptoms within the first few weeks or months of life. These include:
Persistent watering or tearing of one or both eyes
Tears pooling in the eye or running down the cheek
Sticky or crusty discharge, especially after sleep
Mild redness of the eyelids due to irritation
Importantly, the white part of the eye is usually not red. If there is significant redness of the eye itself, this may suggest conjunctivitis or another condition requiring assessment.
Sometimes mucus can collect in the blocked duct, leading to recurrent discharge that can mimic an eye infection.
Management
Most cases improve naturally as the tear duct opens with growth.
Conservative management is the first approach and includes:
1. Tear Duct Massage (Crigler massage)
Parents can gently massage the area between the inner corner of the eye and the side of the nose using a clean finger, applying downward pressure several times a day. This may help open the membrane.
2. Cleaning the Eye
Any discharge can be wiped away with cooled boiled water or sterile saline using clean cotton or gauze.
3. Antibiotic Drops (if needed)
These are only used if there is significant discharge suggesting secondary bacterial infection. They do not resolve the blockage itself.
When Further Treatment Is Needed
If symptoms persist beyond 9โ12 months, referral to an ophthalmologist may be considered. The most common procedure is probing, where a fine instrument is passed through the duct to open the blockage. This is highly successful, especially when performed before 2 years of age.
Rarely, more advanced procedures such as silicone tube insertion may be needed.
Expected Outcome
The outlook is excellent. Around 90% of cases resolve spontaneously during the first year of life, many by 6โ10 months. Babies who require probing generally do very well, with high success rates and minimal long-term problems.
Parents should seek urgent medical review if there is swelling, redness, or tenderness near the inner corner of the eye, fever, or marked irritability, as this could indicate infection of the tear sac (dacryocystitis), which requires prompt treatment.