It is common for babies to have watery eyes. This is usually because the tear duct (also called the nasolacrimal duct), which drains tears away from the eye to the nose, is not yet fully developed. Many people refer to this as a blocked tear duct – but I prefer not to use this term as it implies that there is an actual blockage or problem with the tear duct, when it has actually never opened fully in the first place.
Many people don’t know that we constantly produce tears which are drained away through the tear duct. Of course when we cry or have something in our eye we produce more tears than usual, and they run down our face because they cannot drain away fast enough.
Babies start to produce tears when they are about 1 month old and at this time the tear duct usually starts to function and allows drainage of tears from the eyes to the nose. When the tear duct doesn’t open at the right age the tears can’t drain away and instead will well up in the eye or run down the baby’s face. Sometimes the eyes will appear wet and sticky due to the buildup of tears and the skin under the eye will become irritated from being constantly moist.
These symptoms can be really worrying for parents but it is important to remember that in most cases, it is just a normal part of being a baby.
In the past these symptoms were thought to be because of an actual blockage in the tear duct and from 6 months old babies with these problems would have surgery under general anaesthetic, to force the tear duct open. However research has shown that in almost all cases, the tear duct will begin to function normally by 2 years old without any surgery at all. Therefore it is now very unlikely for children to be offered surgery.
There are some small steps which may reduce the symptoms of watery eye in babies. The most important management is to keep the eye and skin area dry. The best way to do this is to regularly pat it dry with a clean tissue. When the eye is messy it is also important to clean it; this can be done with some cooled boiled water and a clean tissue. However, remember that excessively cleaning or rubbing of the eye will make it red, irritated and uncomfortable. If the eye becomes particularly messy with a yellow sticky discharge antibiotic drops may be prescribed for a few days to clear up the appearance and improve comfort.
Some health care professionals recommend massaging the tear duct to assist it to open. Massage involves firmly pushing the inner corner of the eye with one finger, for a few seconds, several times a day. There is no risk associated with doing this; however the benefits are also unclear.
When you have a child with tear duct problems it is important to be observant of any swelling or redness in the area between the eye and the nose. If this occurs with a fever, it is a sign that the baby may have developed a true blockage or an infection of the nasolacrimal duct, called dacrocystitis, this requires prompt medical treatment.
In some cases a watery eye may also be a sign of other problems such as having an object in the eye or a scratch on the eye; or more seriously congenital glaucoma.