Thursday 18 July 2019

Dear Dr Nina: My 10-week-old baby's eye is constantly oozing

Some newborn babies have immature tear ducts
Some newborn babies have immature tear ducts

Nina Byrnes

Question: My 10-week-old baby has a constantly oozing eye. A friend of mine says her daughter had the same thing and that it was an underdeveloped tear duct which resolved itself. My GP said she never heard of this and referred me to a paediatrician. What do you think? /b>

Dr Nina replies: There a number of conditions that can cause discharge from the eye in a newborn baby. Parents are always worried that this is an infection but that isn't always the case. In newborn babies, recurrent tearing and discharge from the eye may be due to a blocked nasolacrimal duct.

Tears are normally produced in a tear gland in the upper eye and then drain from the eye through the tear duct (nasolacrimal duct) which runs from the inner corner of the eye to the back of the nose. About one in 20 newborn babies will have an immature tear duct. This is usually due to the failure of a membrane at the end of the duct to open at or near the time of birth. This effectively causes a blockage in the drainage system.

Symptoms of this condition include watering or tearing of the eye that starts days or weeks after birth.

There may be sticky discharge at times as the normal process for clearing bacteria from the surface of the eye is impaired. Symptoms sometimes increase during a cold or respiratory infection as tear production may be increased. This condition may cause recurrent bouts of sticky eye.

Thankfully the tear duct issue resolves itself in 90pc of cases by the time the child is 12 months and so specialist review or any kind of procedure is not necessary - unless infections are severe or symptoms persist beyond the first year of life.

Antibiotic drops or ointment may be used if discharge is thick or the conjunctivae is becoming infected or inflamed.

The conjunctiva is the white part of the eye and redness here could suggest infection. If this occurs, a visit to your doctor is warranted. Antibiotics don't clear the duct and discharge can reoccur. Your doctor may swab the eye to identify the bacterial cause of infection.

One way to promote clearing of the duct is to perform nasolacrimal massage.

This involves massaging from the inner corner of the eye to the outer corner of the nose, aiming to clear out the tear duct. Ensure your hand is clean.

Massage downwards using three to five strokes. This may need to be done many times a day.

If symptoms persist more than a year, you may be referred to see an eye specialist, who can perform a procedure to clear or open the duct.

Recurrent sticky eye in newborns is rarely due to other bacterial infections such as chlamydia, gonorrhoea or viral infections.

In these cases, the conjunctivae is usually red and infected and the baby may be unwell.

Thankfully these cases are extremely rare.

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