The next time your little one turns on the water works, consider the benefits of letting her release her pent up emotions before stepping in. Dr Claire Cullen, an ophthalmic surgeon specialising in paediatric ophthalmology says tears provide nutrients and oxygen to help prevent infection and even promote healing. “They help prevent possible dryness and create a nice smooth surface of the front of the eye, which is very important for maintaining clear vision,” she adds.
She answers some common questions around teary eyes in kids.
What causes a teary eye?
Well, it can basically develop at any age. It can also affect only one eye or even both eyes, and is more common in children younger than 12 months. Statistics show that 20% of all newborns will develop a teary eye in the first month of life. But the good news is the majority will spontaneously resolve by themselves!
What are the main causes of a watery eye?
The two main causes of watery eye in your child are:
- Failure of the drainage system (i.e. a blocked tear duct/s)
- Excessive production of tears
What causes a blocked tear duct?
Blocked tear ducts are most commonly caused by a small, persistent membrane called the valve of Hasner. This is a remnant of a membrane that was still present when the baby was developing inside the mother. It lies at the outlet of the nasolacrimal duct, just as the tear drainage system enters the nose. The great news about all babies born with a blocked tear duct, is 95% of blocked tear ducts will resolve on their own within the first year.
If the tear ducts are narrowed or blocked, the tears will not be able to drain away and will build up in the tear sac. This can lead to a constant sticky, gooey eye that is very concerning to most parents.
The majority of the time, this is just a build-up of the normal tear film secretions and can be wiped away regularly with a soft cottonwool ball soaked in sterile water.
(Sterile water needs to be boiled, but make sure it is cooled before dipping the cotton wool into it.)
Motionless tears in the tear sac do, however, increase the risk of infection. It’s almost the same as stagnant water in a stream – it gets dirty. So, if the “regular” discharge becomes plentiful or there is any redness or swelling in or around the eye, it’s best to seek medical advice.
How do I treat my child’s blocked tear duct?
For the majority of cases it’s about patiently waiting and letting the natural growth of the baby’s face take place. Your doctor may recommend something called tear duct massage on a regular basis to try unblock the system.
If, by the age of one, the eye is still tearing, a small procedure called a syringing and probing is recommended. This can be done in the doctor’s rooms for older kids and adults, but for young children a general anaesthetic is required. A small metal probe is used to widen the system and unblock the membrane.
Some children may have a more complex like a complicated type and more involved treatment may be necessary. This might involve inserting a silicone tube into the system to keep it open for several months or surgically creating a new drainage system.
Other less common causes of tear duct blockage in children include scarring due to chronic infections, inflammation, trauma, radiation or mechanical obstruction due to nasal foreign bodies or mucoceles.
What if my child is having an over-production of tears?
Your child’s eyes may be irritated, which may produce more tears than normal as the body tries to rinse the irritant away.
The following irritants can cause the over-production of tears:
- Chemicals such as fumes and even onions
- Infective conjunctivitis
- Allergic conjunctivitis
- An injury to the eye, such as a scratch or a bit of grit
- Trichiasis, where the eyelashes grow inward
- Ectropion, when the lower eyelid turns outward.
Treating an overproduction of tears
The main treatment for overproduction of tears is to address the cause and tailor the treatment accordingly. This might include removing the irritant or treating the infection or allergy.
What are the more serious causes of a watery eye?
It’s always safe to rather have your child’s eyes examined as some of the more serious causes of watery eye can affect your child’s vision.
These serious conditions include:
- Keratitis, an infection of the front of the eye
- Corneal ulcer, an open sore that forms on the eye
- Congenital glaucoma (high pressure in the eye)
These conditions need prompt treatment to help prevent vision loss. Pediatric ophthalmologists understand the unique needs of children and it’s always a good idea to consider visiting one for your child.
Did you know?
The tear film actually consists of two layers. A watery layer, which makes up 95% of the tear film and is produced by a little gland that sits just under the outer part of the eyebrow. And a lipid or fatty layer that is secreted by little glands in the eyelid called Meibomian glands. These little glands are the ones that create lumps or chalazions (cysts on the eyelid) if they get blocked.
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