Blocked tear ducts occur in 6 percent of all babies. Parents may not notice anything wrong because some babies do not produce tears until they are 3 to 4 weeks old.

Tears normally flow through the tear duct from the eye to the nose. When a tear duct is blocked, the eye is constantly “watering” so that even if the child isn’t crying, tears run down his or her face. When the child cries, the nostril on the blocked side stays dry. Unless the tear duct is infected, the eye is not red and the eyelid is not swollen.

Blocked tear ducts usually open up by the time a baby is six months to 1 year old. In the few children where the problem does not correct itself, an ophthalmologist may perform outpatient surgery at 9 to 10 months of age.

“Most of the time, a blocked tear duct resolves itself, but in rare cases surgery is required,” said Dr. Evelyn Paysee, ophthalmologist at Texas Children’s Hospital. “Parents should know that surgery for a blocked tear duct normally takes about 20 minutes, brings immediate relief to the child, and recovery is quick.”

Massage of the lacrimal sac, the place where tears collect, is the home treatment of choice. To do this:

• Wash your hands carefully.
• Place your finger alongside the child’s nose, with your fingertip at the inner corner of the eye. This is where the lacrimal sac is located.
• Press very gently, rolling your finger back and forth. Yellowish fluids may come out of the eye’s inner corner.
• Massage for approximately 1 minute, two times a day.

If the tear duct becomes infected, your doctor may prescribe antibiotic drops. Signs of infection are red or swollen eyelids, or a red lump in the inner lower corner of the eyelid.