Tearing in children

In about 5% of babies the naso-lacrimal duct has not fully opened at birth. Consequently the child is noted to have constantly watery or sticky eyes as the mucous tears cannot drain into the nose. This is known as Congenital Naso-lacrimal Duct Obstruction. Fortunately this self resolves in the vast majority of cases (approximately 90%) in the first few months of life and no action is required. In the remaining 5-10% of children the problem persists and often topical antibiotic drops or ointment are required if infection develops.

Management

Treatment is generally recommended if there has been no improvement by the age of 12 months. Studies show that intervention improves outcome at this age. The management is to perform a Syringe and Probe with endoscopic guidance (a small telescope with a light) under general anaesthetic as a day case. The technique, which is about 90% successful, involves opening up the passageway by passing a very fine probe down into the nose. Occasionally other small procedures to open up more space in the nose are required at the same time and in a few cases it is necessary to insert tubes into the system to try and ensure that a good tear drainage channel develops.