What to do if your child has a blocked tear duct

Even though a blocked tear duct is something no one can foresee, it is always good to stay informed, especially when it is something that experts say is surprisingly common among children.

Here is what you need to know and what you can do if your child’s tear duct gets blocked:

How does a child’s tear duct get blocked?

According to optometrist, Lehandré van der Merwe from The Family Optometrist in Pretoria, congenital blockage, infections and injury or trauma are all possible causes for blocked tear ducts in children.

Congenital blockage

Some infants are born with an obstructed or a mispositioned tear duct. Babies’ tear drainage systems are also not always fully developed yet, or they may have a lacrimal pump failure. Some children are born with a thin membrane covering their tear duct, which may cause the duct to drain into their nasal canals.

Infections

Chronic infections could also cause the blockage of tear ducts. Blepharitis (inflammation of the eyelashes), conjunctivitis (inflammation of the eye’s protective membrane) and viral infections like sinusitis can all lead to a tear duct getting blocked.

Injury or trauma

As children play outside, dirt can also cause tear ducts to get blocked. “In severe cases where an injury to the face includes bone damage or scarring near the nose, it might lead to a tear duct blockage as well,” says family optometrist, Lehandré van der Merwe.

In severe and very rare cases, a blocked tear duct may also be due to a nasal tumour, which is why it is essential to consult an optometrist or ophthalmologist rather sooner than later, especially if your child is struggling with recurrent infections.

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Can it affect your child’s eye or eyesight in the long run?

Van der Merwe says: “Blocked tear ducts may lead to tenderness of the eyelid, a watery eye and swelling along the lash line due to the eye’s inability to drain tears normally.”

Symptoms of a blocked tear duct may include:

• Epiphora (excessive tearing)
• Redness of the sclera, which is the white part of the eye
• Tenderness, swelling and pain of the eyelids (especially inside the eye)
• In some cases, the child’s eyelashes may stick together due to the discharge from the eye
• Eyelids may look like they have crusts
• The inflammation in the eye may cause blurry vision

How can you treat it at home?

The most successful at-home treatment (and probably the oldest in the book) is a warm compress:

1. Warm up a clean, soft face cloth and gently clean the eye by wiping the cloth over the eye from the inside out.
2. Leave the warm compress over your child’s eye for five to 10 minutes and thereafter, massage the tear duct by placing your index finger on the inner part of your child’s eye right next to the nose and firmly massaging downwards.
3. Apply 10 strokes, four times per day after the warm compress. (You may want to work on your story-telling skills too, as getting a three-year-old to keep still for five minutes can be a daunting task).
4. If there is discharge present in the eye, an over-the-counter drop with antibiotic properties like Brolene might come in handy.

When do you need to consult a specialist?

If the at-home treatment doesn’t bear fruit and the eye has been teary and swollen for several days, or if your child is complaining of pain, you might want to consult an eye specialist.

Dr Cor van Zyl is based at the Eye Institute in Arcadia, Pretoria and he is especially good with children. He might suggest a small eye operation to drain the duct and although it is under anaesthetics and your child will need to go for a Covid-19 PCR test, both the surgery and the recovery time is quick.

If your child is struggling with recurrent infections, consider consulting an ophthalmologist.

How can you prevent it from getting blocked again?

Keeping children’s hands clean and out of their faces is almost impossible. Luckily, with Covid-19 in our midst, children wash their hands more often now than ever before.

Teach your children to wash hands regularly and to refrain from touching or rubbing their eyes, especially when playing outside or when they have the flu or a sinus infection.

Also, make it part of the daily bath routine to gently wash your child’s eyelids and lashes with a warm, soft facecloth. Clean their faces, lids and lashes thoroughly at least twice a day.

You can also buy Dr Chrissanthie’s Baby Eyelid Cleanser Lid Wipes with Chamomile from your local optometrist. These wipes remove allergens, dust and dirt from your child’s eyelids and the soothing

Chamomile extract has anti-inflammatory and antibacterial properties that gently removes the crusting around the eye area.

It’s suitable for newborns and there is no need to rinse your child’s face after using the wipes. It’s also alcohol, preservative and fragrance free.