Nasolacrimal duct obstruction (NLDO) is the most common cause of persistent tearing in an infant/ young child, and can lead to infection and ocular discharge. Other causes range from mild, self-limiting conditions (eg. Viral or allergic conjunctivitis) to severe sight-threatening ocular emergencies (eg. ophthalmia neonatorum or eye infection in a newborn).
Causes of tearing in an infant/ young child
Nasolacrimal duct obstruction (NLDO)
- A blocked tear duct stops the flow of tears from the eye down the lacrimal duct into the nose.
- Massaging the eye
- Gently rubbing (massaging) the lacrimal sac will often help open the tear duct. You will usually need to do this four to six times a day. Your doctor will explain how to massage the lacrimal sac.
- If your child has an infection, the doctor may prescribe antibiotic drops or ointment .
- Your child will only have surgery if other medical treatments do not work.
- Massaging the eye
- Pink eye is most often caused by viral infections associated with the common cold. It can also be caused by bacterial infections or allergies.
- Children with bacterial pink eye should take antibiotic drops or ointment. These are not needed for viral pink eye.
- Viral and bacterial pink eye are contagious. Prevent them from spreading with good hand washing and use of alcohol-based hand rubs.
- Pink eye should not cause any long term damage to a child’s vision.
- Seek medical attention if there is a change in vision, persistent redness, eye pain, or eyelid swelling.
This is an eye infection in a newborn child. There may be discharge and difficulty opening the eyes.
Most common → Neisseria gonorrhea, Chlamydia
Herpes Simplex Virus (1-2 weeks after birth, vesicles on face, herpetic dendritic keratitis)
- Samples of the discharge and swab of the conjunctival/eye white would be sent for microbiological diagnosis
- Blood work may need to be done if child has fever
- Start broad spectrum antibiotic eyedrops
- Keep the eye clean with saline lavage
- Close follow up until cause known
- Tailor treatment according to infection results/sensitivity
- Child may also require oral antibiotics or even admission for medications if the cause is a bacteria that can cause damage to other organs.