Blocked Tear Ducts

Blocked tear ducts, also known by the medical term "nasolacrimal duct obstructions," are very common in children and infants. When a tear duct system hasn’t fully developed, it can lead to blockage, excessive tearing and infection. Many cases of blocked tear ducts clear by themselves during the first year of life.

What are symptoms of blocked tear ducts?

Symptoms of a blockage include an overflow of tears, as well as red, swollen eyelids, and possibly a yellowish-green discharge from a build-up of bacteria in the tears.

How are blocked tear ducts diagnosed and treated?

If the tear duct obstruction does not resolve by itself, one or more of the following treatments may resolve the issue:

  • tear duct massage
  • topical antibiotic eye drops
  • tear duct probing 
  • balloon tear duct dilation
  • tear duct intubation

Sometimes if a blockage is severe, a doctor might recommend tear duct obstruction surgery.

Pinkeye (Conjunctivitis)

About Pinkeye

Conjunctivitis, commonly known as pinkeye, is an inflammation of the conjunctiva, the clear membrane that covers the white part of the eye and the inner surface of the eyelids.

Pinkeye can be alarming because it may make the eyes extremely red and can spread rapidly. But it's a fairly common condition and usually causes no long-term eye or vision damage.

Still, if your child shows symptoms of pinkeye, it's important to see a doctor. Some kinds of pinkeye go away on their own, but others require treatment.

Causes

Pinkeye can be caused by many of the bacteria and viruses responsible for colds and other infections, — including ear infections, sinus infections, and sore throats — and by the same types of bacteria that cause chlamydia and gonorrhea, two sexually transmitted diseases (STDs, also called sexually transmitted infections, or STIs).

Pinkeye also can be caused by allergies. These cases tend to happen more frequently among kids who also have other allergic conditions, such as hay fever. Triggers of allergic conjunctivitis include grass, ragweed pollen, animal dander, and dust mites.

Sometimes a substance in the environment can irritate the eyes and cause pinkeye, such as chemicals (chlorine, soaps, etc.) or air pollutants (smoke and fumes).

Pinkeye in Newborns

Newborns are particularly susceptible to pinkeye and can be more prone to serious health complications if it goes untreated.

If a baby is born to a mother who has an STD/STI, during delivery the bacteria or virus can pass from the birth canal into the baby's eyes, causing pinkeye. To prevent this, doctors give antibiotic ointment or eye drops to all babies immediately after birth. Occasionally, this preventive treatment causes a mild chemical conjunctivitis, which typically clears up on its own. Doctors also can screen pregnant women for STDs/STIs and treat them during pregnancy to prevent transmission of the infection to the baby.

Many babies are born with a narrow or blocked tear duct (called lacrimal duct stenosis), which usually clears up on its own. Sometimes, though, it can lead to conjunctivitis.

Symptoms

The different types of pinkeye can have different symptoms. And symptoms can vary from child to child.

One of the most common symptoms is discomfort in the eye. A child may say that it feels like there's sand in the eye. Many kids have redness of the eye and inner eyelid, which is why conjunctivitis is often called pinkeye. It can also cause discharge from the eyes, which may cause the eyelids to stick together when the child awakens in the morning. Some kids have swollen eyelids or sensitivity to bright light.

In cases of allergic conjunctivitis, itchiness and tearing are common symptoms.

conjunctivitis illustration

Contagiousness

Cases of pinkeye that are caused by bacteria and viruses are contagious; cases caused by allergies or environmental irritants are not.

A child can get pinkeye by touching an infected person or something an infected person has touched, such as a used tissue. In the summertime, pinkeye can spread when kids swim in contaminated water or share contaminated towels. It also can be spread through coughing and sneezing.

Doctors usually recommend keeping kids diagnosed with contagious conjunctivitis out of school, childcare, or summer camp for a short time.

Also, someone who has pinkeye in one eye can inadvertently spread it to the other eye by touching the infected eye, then touching the other eye.

Preventing Pinkeye

To prevent pinkeye caused by infections, teach kids to wash their hands often with warm water and soap. They also should not share eye drops, tissues, eye makeup, washcloths, towels, or pillowcases with other people.

Be sure to wash your own hands thoroughly after touching an infected child's eyes, and throw away items like gauze or cotton balls after they've been used. Wash towels and other linens that the child has used in hot water separately from the rest of the family's laundry to avoid contamination.

If you know your child is prone to allergic conjunctivitis, keep windows and doors closed on days when the pollen is heavy, and dust and vacuum frequently to limit allergy triggers in the home. Irritant conjunctivitis can only be prevented by avoiding the irritating causes.

Many cases of pinkeye in newborns can be prevented by screening and treating pregnant women for STDs/STIs. A pregnant woman may have bacteria in her birth canal even if she shows no symptoms, which is why prenatal screening is important.

Treatment

Pinkeye caused by a virus usually goes away on its own without any treatment. If a doctor suspects that the pinkeye has been caused by a bacterial infection, antibiotic eye drops or ointment will be prescribed.

Sometimes it can be a challenge to get kids to tolerate eye drops several times a day. If you're having trouble, put the drops on the inner corner of your child's closed eye — when the child opens the eye, the medicine will flow into it. If you continue to have trouble with drops, ask the doctor about antibiotic ointment. It can be applied in a thin layer where the eyelids meet, and will melt and enter the eye.

If your child has allergic conjunctivitis, your doctor may prescribe anti-allergy medication, which comes in the form of pills, liquid, or eye drops.

Cool or warm compresses and acetaminophen or ibuprofen may make a child with pinkeye feel more comfortable. You can clean the edges of the infected eye carefully with warm water and gauze or cotton balls. This can also remove the crusts of dried discharge that may cause the eyelids to stick together first thing in the morning.

If your child wears contact lenses and has conjunctivitis, your doctor or eye doctor may recommend that the contact lenses not be worn until the infection is gone. After the infection is gone, clean the lenses carefully. Be sure to disinfect the lenses and case at least twice before letting your child wear them again. If your child wears disposable contact lenses, throw away the current pair and use a new pair.

When to Call the Doctor

If you think your child has pinkeye, it's important to contact your doctor to learn what's causing it and how to treat it. Other serious eye conditions can mimic conjunctivitis, so a child who complains of severe pain, changes in eyesight, swelling around the eyes, or sensitivity to light should be examined. If the pinkeye does not improve after 2 to 3 days of treatment, or after a week when left untreated, call your doctor.

If your child has pinkeye and starts to develop increased swelling, redness, and tenderness in the eyelids and around the eye, along with a fever, call your doctor. Those symptoms may mean the infection has started to spread beyond the conjunctiva and will require additional treatment.

Reviewed by: Yamini Durani, MD
Date reviewed: May 2012