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Tears flow from the eye to the nose via a narrow tube called the nasolachrymal duct or tear duct. About 1 in 50 babies are born with some degree of blockage in one or both of these ducts.

Cause

The cause for a blocked tear duct is uncertain although it is thought to be due to a retained plug of mucus or cells. The blockage is usually present at birth, but may not become obvious until your baby is around 1 month old.

Clinical features

If your baby has a blocked tear duct, his eye will be constantly watering. The eye is otherwise perfectly normal.

Treatment

Massaging the inner lower corner of the eye several times a day can encourage the duct to open, but only do this under guidance from your doctor. Make sure your hands are clean and using your little finger massage in a downward direction starting from the tear sac in the corner of the eye. If despite this treatment the tear duct remains blocked after your child has reached 6 months of age, your doctor may refer you to a specialist, who may suggest passing a fine probe under general anaesthetic to open up the duct.

When to see your doctor

• if there is a greenish discharge from the eye, which may mean the eye has become infected. It is important to stop massaging as soon as you suspect that your child has an eye infection;

• if the tear duct is still blocked after your child has reached 6 months of age.

Cataracts are a clouding over of the lens of the eye and are rare in children. Certain conditions are associated with cataract formation in children, such as the mother contracting rubella during her pregnancy. In most cases the cause is unknown. If left untreated, cataracts can lead to blindness. Surgery is usually indicated.

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