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Children’s Health Queensland Hospital and Health Service Children’s Health Queensland Hospital and Health Service

Blocked tear duct (nasolacrimal duct obstruction) fact sheet

Blocked tear duct (nasolacrimal duct obstruction)

Watery eyes in young children are often caused by a problem with the tear drainage of the eye. Tears normally drain through small openings in the corners of the eyelids and enter the nose through small tubes (nasolacrimal ducts). When the nasolacrimal duct becomes blocked or obstructed, it may cause:

  • Tears to run down the cheeks
  • A sticky discharge to develop
  • Swelling and redness of the lower lid

Most watery eyes will get better before the child’s first birthday without any treatment. The most common cause is a membrane blocking the nasolacrimal duct. The membrane usually breaks open as your child’s face grows.

Care at home

Nasolacrimal duct massage
This may help to clear any blockage. The method for massaging is as follows:

  1. Wash your hands and ensure your fingernails are short.
  2. With the tip of your forefinger, apply moderate to firm pressure to the side of the nose, where the upper and lower lids join, and slide the finger downward for a short distance (1 – 2 cm) whilst maintaining pressure.
  3. Repeat five times, twice a day.

Keep the eye clean
Due to tears pooling in the eye, infections can occur. This can cause a yellow/green discharge and sometimes red and itchy/irritable eyes. This can be avoided or treated by washing the eyelids and face frequently with a clean facecloth. The eye can be bathed and flushed once to twice per day with a salt solution made using the following method:

  1. Boil water.
  2. Put 1 teaspoon of ordinary table salt in a clean cup.
  3. Add 250ml of boiling water and stir to dissolve salt.
  4. Allow to cool to room temperature.

Thoroughly clean your hands before and after you bathe the eye and surrounding areas with the solution.
Antibiotic eye drops
If the cleaning of the eye is not successful in reducing an infection, a short course of antibiotic drops may be required. These can be obtained from your doctor.
If any of the following symptoms occur, seek advice from your doctor immediately:

  • Significant swelling of the eyelids or surrounding area with bluish or red discolouration of the skin.
  • Sticky eye with severe amounts of discharge.
  • Extreme or increasing sensitivity to bright light.
  • Increase in the size of the eyes, or difference in size between the eyes.
  • Clouded or hazy view of the coloured part of the eye.

Will surgery be needed?

Your child may need an operation if their tear duct remains blocked after several months of medical treatment. This will be conducted as day surgery under a general anaesthetic and may involve:

  • Probing and irrigating – to open and flush out the tear duct.
  • Silicone tube insertion – inserting a tube to keep the duct open. This will be left in for a few weeks to ensure the blockage doesn’t reoccur.
  • Dacryocystorhinostomy – to make a new opening in the tear sac and the bone in the nose.

Your doctor will identify the best surgery option for your child.

Contact us

Outpatients – Ophthalmology (2d)
Level 2, Queensland Children’s Hospital
501 Stanley Street, South Brisbane
t  07 3068 2630  |  07 3068 1111 (general enquiries)

In an emergency, always call 000.

If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.

Resource no. FS306. Developed by the Ophthalmology Department. Updated: May 2018.
All information contained in this sheet has been supplied by qualified professionals as a guideline for care only. Seek medical advice, as appropriate, for concerns regarding your child’s health.