Blocked Tear Ducts and Sticky, Crusty Eyes in Babies

What's happening

• Tears drain through a tiny duct from the inner corner of the eye into the nose. In some newborns, a thin membrane at the end of the duct hasn't opened yet.
• It affects roughly 1 in 20 babies, sometimes both eyes. Signs usually start in the first weeks.
• Most clear on their own: the large majority by the first birthday.

Typical signs

• A watery eye, even when not crying; tears welling and rolling down the cheek.
• Crusty lashes, especially after sleep, and a little yellow or white mucus in the inner corner.
• The white of the eye stays white, and the eyelid isn't swollen or red.
• It often gets worse with a cold, because the nose gets blocked too.

Daily care

1. Wash your hands.
2. Moisten a clean cotton ball or soft cloth with warm, previously boiled or clean tap water.
3. Wipe from the inner corner outward, once. Use a fresh cotton ball for each wipe and each eye.
4. Do this as often as needed to keep lashes clean.
5. No breast milk, tea or other home remedies in the eye. They aren't proven and can carry germs.

Tear duct massage

• Many pediatricians suggest gentle massage to help open the membrane. Ask at a visit to be shown how.
• With a clean fingertip (short nail), press lightly over the bump of the tear sac, at the inner corner beside the nose, and stroke downward toward the nostril a few times.
• Do it 2-3 times a day, for example at diaper changes.

Blocked duct, or something else?

• Conjunctivitis (pink eye): the white of the eye turns pink or red, often with thicker, more constant discharge. In a newborn, red eyes with discharge need prompt attention, because some infections passed at birth need treatment quickly.
• Infection of the tear sac: a red, swollen, tender lump at the inner corner, sometimes with fever.
• Glaucoma in babies is rare but serious: tearing with a cloudy or enlarged eye, sensitivity to light, or the baby squeezing the eye shut.

If it doesn't clear

• If it's still blocked around 12 months, the pediatrician may refer you to a pediatric eye doctor. A short procedure to open the duct is common and works well. Some doctors offer it earlier for frequent infections.

When to check in

• Mention watery or crusty eyes at the next checkup, and again if it's still there around 9-12 months.
• Contact the pediatrician the same day for red or pink whites of the eye, swollen or red eyelids, a red lump at the inner corner, a cloudy-looking eye, or a baby who keeps the eye shut in light.
• Any fever of 100.4°F (38°C) or higher (rectal) in a baby under 3 months needs a call to the pediatrician right away.