When the Tears Won’t Stop

watery eyesEverything about our eyes is complex, even the method in which they maintain moisture — tears. Usually, the eyes have just enough tear fluid continually passing through them to keep them wet. But some very young children appear to be constantly awash in tears, and they have nothing to do with any emotional causes.

What gives? Probably a case of blocked nasolacrimal ducts, a condition that Dr. Shams can correct.

What is the nasolacrimal duct?

Tears normally do their job lubricating the eyes and then exit through tiny openings on the edges of the eyelids. These openings then drain into the nose through little tubes, the nasolacrimal ducts. These ducts start underneath the skin at the corners of the eyes by the nose. They then go down through the bones of the face and actually open on the inside of the nose. This explains why something making your eyes water, like an allergy, also seems to make your nose run because the tears exiting through the nasolacrimal ducts.

What is nasolacrimal duct obstruction?

Sometimes babies are born and their nasolacrimal ducts aren’t fully open yet. This makes the baby have watery eyes for a while, but most children grow out of it and normal drainage begins. But sometimes when the ducts don’t naturally open tear fluid builds up inside the duct and can become infected. This can eventually lead to permanent blockage called nasolacrimal duct obstruction.

How will Dr. Shams know if my child has an obstruction?

There are two telltale signs that a child has a nasolacrimal duct obstruction.

1.The child has an overabundance of tears but his or her eyes are not red or irritated. Red eyes would point to an infection, allergy, injury, or the like that would be causing the tearing.

2.The tears have a yellowish, cloudy tone.

Possible treatment

Dr. Shams may first recommend a simple treatment to try and open the duct — placing a warm washcloth on the child’s eye a few times each day to try and help the fluid in the duct drain. Massaging between the child’s eye and nose is a second facet of this simple treatment.

Surgical solutions

The duct can take months to open with the treatment above, and the obstruction could be causing problems in the meantime. In these cases, Dr. Sham will perform a procedure called nasolacrimal duct probing. With the child under general anesthesia, Dr. Shams passes a thin wire probe through the opening in the eyelid down the nasolacrimal duct into the nose. This often opens the duct and removes the blockage.

However, sometimes this probing can actually cause the duct to block completely. If this happens, the fluid will continually become infected. To fix this situation, Dr. Shams will operate to place a small plastic tube inside the duct that will stay there for several weeks, even months. Once removed, the duct usually remains open and the problem is solved.

If your child seems to have overly watery eyes, he or she may have a nasolabial duct obstruction. Call Dr. Shams and schedule an appointment to have the problem looked at.

Posted in: Eye Care, Watery Eyes

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My NHS practice is based at the world-renowned Moorfields Eye Hospital in London. I consult private patients at Moorfields Private Eye Hospital, Optegra London Eye Hospital and The Harley Street Clinic.