Nasolacrimal duct obstruction in infants

The nasolacrimal duct, which generally opens spontaneously in neonates, sometimes remains closed during the first weeks and months of life. In this case, the eyes may often water and become inflamed.

Whenever you change your baby’s diaper, you should massage the nasolacrimal duct from outside. Place your index finger on the side of your child’s nose and apply gentle pressure to move your fingertip upwards to the inner medial angle of the eye. Nasolacrimal obstructions occasionally lead to infection and chronic inflammation of the eye. In these cases, it is necessary to administer antibiotic or decongestant eye drops into the lower conjunctival sac of your child, following the instructions of your ophthalmologist. This should be done after the described fingertip massage.

In rare cases, the nasolacrimal duct does not open by itself within the first 12 months. If the nasolacrimal duct is still closed by the end of the first year of life, your ophthalmologist needs to perform surgical probing and irrigation of the nasolacrimal duct in a short procedure under general anaesthesia. This procedure is, however, not done before the end of the 12th month of life, because:

1. the nasolacrimal duct has usually opened of its own accord by then, and
2. the risk of injuring the mucous membrane of the nasolacrimal duct through surgical procedures (probing and irrigation) is considerably lower after this period.