# Tear Duct Obstruction in Children and Infants

Source page: https://www.kudretgozistanbul.com/en/treatments/tear-duct-obstruction-in-children-and-infants

**Author:** Kudret Eye İstanbul | **Medical Approval:** Op. Dr. Nail Sönmez | **Date:** 2026-09-14

> **Summary:** A blocked tear duct is common in newborns and usually clears on its own within the first 12 months without treatment. Constant watering, discharge and crusting are typical signs; tear sac massage, antibiotic drops and probing are used when needed, with further procedures only if these fail.

## Quick Facts
- **Natural Course:** Usually opens within the first 12 months
- **Probing:** Usually planned around the first year of age
- **Probing Anaesthesia (children):** Usually brief anaesthesia
- **First Tears in Babies:** Usually 1-3 months after birth

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## What Is Tear Duct Obstruction?
Tears from the lacrimal glands spread over the eye with each blink and the excess drains into the nose through the tear ducts. A partial or complete blockage stops this drainage. The duct may be congenitally narrow or closed, or become blocked later.

## Symptoms
- Constant watering of the eye.
- Redness or pinkness and irritation.
- Crusting or discharge around the eye; crusted lashes especially on waking.
- Pus coming from the eye when the root of the nose is pressed.
- Swelling at the root of the nose.

## Treatment
- **Tear sac massage:** Applied during the first year while waiting for the duct to open.
- **Antibiotic drops or ointment:** For infection, by prescription.
- **Probing:** If the duct does not open and symptoms continue.
- **Silicone tube intubation or balloon dacryoplasty:** Tried if massage, drops and probing do not fully clear the blockage.
- **Dacryocystorhinostomy (surgery):** If these also fail, usually once the child is older.

### How to Do Tear Sac Massage
- With a fingertip at the inner corner beside the bridge of the nose, over the tear sac, press gently downwards.
- The doctor shows how often and for how long.
- Wash hands, keep nails short, and press on the sac, never on the baby's eye.

### When Is Probing Needed?
- Usually around the first year, per the doctor's assessment; in the early months waiting is common because the duct often opens by itself.
- Repeated infections, lid margin redness or swelling over the tear sac alongside watering may bring the assessment forward.

### After Probing
- A short procedure; slightly blood-stained watering for a few days is expected.
- Use the prescribed drops as directed and keep the follow-up; if symptoms return, a second assessment may be needed.

## Price
The price depends on the cause and the procedure; the plan is set individually after a detailed examination.

## About the Hospital
Over 24 years in eye care, three eye hospitals and a general hospital, specialist surgeons for each treatment, and lifetime aftercare.

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## Frequently Asked Questions (FAQs)

**Q: Can artificial tear drops be used in children?**
A: Generally yes, but only when recommended by an ophthalmologist.

**Q: When do babies have their first tears?**
A: Usually between 1 and 3 months after birth, because the lacrimal glands are not fully developed at birth.

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## References
- Nasolacrimal Duct Obstruction, AAPOS
- Nasolacrimal Duct Obstruction, Congenital, EyeWiki (AAO)