Key takeaways: About 1 in 20 babies has a blocked tear duct, causing watery eyes and crusting. Most clear on their own by 12 months. Gentle massage and cleaning help. Red, swollen eyelids, a swollen bump near the nose, or eye discharge in the first weeks need a doctor.
It’s common to notice your baby has a watery eye or crusty lashes after sleep. Often, the cause is a blocked tear duct.
What Is a Blocked Tear Duct?
Tears normally drain through tiny openings in the inner corners of the eyelids, into a duct that leads into the nose. In some babies, a thin membrane at the end of the duct doesn’t open fully at birth. This is called nasolacrimal duct obstruction. It affects roughly 5 to 20 percent of newborns.
Signs
- Watery eye, with tears spilling onto the cheek even when not crying.
- Yellow or white mucus in the inner corner of the eye.
- Crusting on the lashes, especially after sleep.
- Usually one eye, but can be both.
- The white of the eye is not red.
Treatment
Cleaning: wipe away discharge with a clean, warm, damp washcloth or cotton ball, from the inner corner outward. Use a clean area for each wipe and each eye.
Tear duct massage: your doctor may recommend gently massaging the duct. With a clean finger, press gently on the side of the nose near the inner corner of the eye and stroke downward a few times, 2 to 3 times a day. Ask your doctor to show you.
Antibiotic drops: may be prescribed if there are signs of infection.
Outlook
Most blocked tear ducts open on their own. Studies show about 90 percent resolve by 12 months. If it hasn’t cleared by around 12 months, your doctor may refer you to a pediatric ophthalmologist for a simple procedure to open the duct.
Other Causes of Eye Discharge
- Conjunctivitis (pink eye): redness of the white of the eye, swollen eyelids, and discharge. In newborns, it can be serious, especially in the first weeks.
- Chemical irritation from eye ointment in the first day or two.
- Colds can cause watery eyes.
Call your baby’s doctor promptly if your baby:
- Has eye discharge or redness in the first 2 to 4 weeks of life. Some newborn eye infections need urgent treatment.
- Has a red, swollen eyelid or skin around the eye.
- Has a firm, red, swollen bump near the inner corner of the eye (a possible infected duct).
- Has a red white of the eye, or seems bothered by light.
- Has a cloudy or enlarged-looking cornea, or excessive tearing with light sensitivity (rare, but can signal glaucoma).
- Has fever along with eye symptoms.
The Bottom Line
A watery, crusty eye with a clear white is usually a blocked tear duct that clears on its own. Clean gently, massage as instructed, and call for redness, swelling, or eye problems in a newborn.
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Sources
- Pediatric Eye Disease Investigator Group. Resolution of congenital nasolacrimal duct obstruction with nonsurgical management. Arch Ophthalmol. 2012;130(6):730-734.
- MacEwen CJ, Young JD. Epiphora during the first year of life. Eye (Lond). 1991;5(Pt 5):596-600.
- American Association for Pediatric Ophthalmology and Strabismus. Nasolacrimal duct obstruction. https://aapos.org
- US Preventive Services Task Force. Ocular prophylaxis for gonococcal ophthalmia neonatorum: US Preventive Services Task Force reaffirmation recommendation statement. JAMA. 2019;321(4):394-398.
- American Academy of Pediatrics. Blocked tear ducts. HealthyChildren.org. https://www.healthychildren.org
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
