Pediatric Tear Duct (Nasolacrimal Duct) Anomalies

The main cause of tear duct anomalies is some type of obstruction, including:

• A membrane at the end of the tear duct that does not open around birth
• Missing parts of the lacrimal system, from the punctum (opening at the lid) to the canaliculus (small duct that connects to the lacrimal sac) to the tear duct itself  
• Bony blockage of the tear duct

Newborns usually show symptoms of tear duct anomalies within a few weeks of birth. These include:

• Eyes that tear (water) constantly
• Red, swollen eyelids that may develop a crust
• Yellowish-green discharge

Often, your baby’s pediatrician will be able to diagnose tear duct anomalies and, if needed, will refer to an ophthalmologist for proper management.

Tear duct anomalies often clear up without surgical treatment in the first 6 to 8 months of age. When treatment is necessary, the options we recommend at Children’s National Hospital include:

• Gentle cleaning of any discharge from the eyes with a warm, wet washcloth
• Massaging of the tear ducts to help expressing the infection/discharge out
• Antibiotic eye drops or ointment to prevent or treat infection
• Surgery to open the tear ducts if the condition persists