Good Hope, Heartlands, and Solihull Eye Clinics

Watery Eyes in Children

David Kinshuck

 

 

Normal tears

Tears are made in a gland under the skin above the eye. They flow over the front surface of the eye, and drain into tiny tear ducts in the eyelids, near the nose (under the skin).

Then they flow into a tear 'sac', and from there they pass through a wide channel, the 'naso-lacrimal duct' into the inside of the nose.

healthy tear flow over the eye into the nose:

 

healthy tear flow over the eye into the nose:

flow of tears over the eye

 

Blocked naso-lacrimal duct

Babies whose eyes water are usually born with a tear duct that is slightly narrow. In 90% the tear duct will widen by itself by the age of 2 years and the eyes will stop watering. Indeed, many children's eyes will have stopped watering by the age of 1 year.

Such babies may develop conjuctivitis every now again. That is, the eye goes red and sticky with a discharge. Antibiotic drops from your family doctor help get this better quicker. A few babies develop this repeatedly: ask you doctor if you can have a spare prescription in case this happens.

These infections usually start to clear as the duct opens, usually by the age of one.

Blocked naso-lacrimal duct

Blocked naso-lacrimal duct

 

Probing

probing of the naso-lacrimal duct

probing of the naso-lacrimal duct

Usually, in 90% of babies, the tear duct will open by itself, but if not, a small operation can help. This is called 'probing' and this will open most blockages. It is very gentle, but does need a general anaesthetic.

There are unusual children born with slightly more complicated problems, and for these different operations may be necessary.

Here are some outcomes JPOS 15.

 

 

 

Infection of the tear sac, acute dacrocystitis

Infection of the tear sac, acute dacrocystitis

 

A few children with a blocked tear duct can develop an infection in the tear sac. This is quite uncomfortable, just like an abscess anywhere else in the body. It is called 'acute dacrocystitis'. This begins as a blocked tear duct and watery eye. The tears then get trapped in the tear sac, and stagnate. The stale tears may then become prone to infections.

Infection of the lacrimal sac, treated as below. Usually an operation is necessary after acute dacrocystitis.

 

 

The treatment for an infection of the tear sac.

  1. Attend the nearest eye emergency department/service (you may need to contact yor GP first).
  2. Bathe the 'abscess' with a warm tissue four times a day.
  3. Your baby will need antibiotics
  4. Sometimes the abscess needs draining.