Chronic or overflow tearing in children may be due to a common obstruction of the normal outflow system (nasolacrimal duct obstruction). In such cases, children often have chronic tearing from birth which may be associated with crusting of the lashes, particularly in the morning, as well as discharge. In many cases, the system will spontaneously open within a few months of birth. However, other conditions such as infection, glaucoma, and intraocular inflammation may also be present with similar signs and symptoms. Only your pediatric ophthalmologist can determine if other conditions are present.
Your pediatrician may recommend warm compresses and daily massage. If massage is employed, it should be applied in a gentle pressing motion against the upper most portion of the nose adjacent to the nasal corner of the eyelids. Antibiotic drops or ointment may be recommended if discharge or crusting is present.
In cases of chronic tearing for months or significant infection, the obstruction can be removed in many cases with a simple procedure. The procedure can be performed in either the office setting or in an operating room. The procedure is not painful and often the symptoms improve within a few days. As with any surgical procedure, infection or bleeding can occur, or scarring can re-obstruct the opening, and require additional surgery. Currently, based on a recent study of nasolacrimal duct obstruction, our practice's success rate is approximately 86-90% with one procedure.