Nasolacrimal Duct Obstruction Management
(Blocked Tear Duct)

 

1. Nasolacrimal duct massage – two times a day

  • The main purpose of nasolacrimal duct massage is to remove discharge that collects in the lacrimal sac located in the side of the nose by the eye.
  • Place your thumb (right thumb, baby’s right eye) against and deep into side of nose at the corner of the eye.
  • With counter pressure using your other four fingers on baby’s opposite temple, press thumb in towards side of nose with firm pressure to blanch skin using slight circular movement.
  • With sufficient pressure over the lacrimal sac, you can sometimes create a force down into the tear duct that clears the obstruction.
  • If the discharge or infections disappear, you may skip this step but continue with step #2 and massage only should the infection reoccur.

2. Wash eyelids - two times a day – Wash with a sudsy baby washcloth soaked with warm water and a dab of no-tear baby wash or shampoo (Johnson’s baby shampoo is very mild).

3. If the yellow discharge persists after 2-3 days, continue steps 1 and 2 and apply an antibiotic drop or ointment (provided by doctor) after washing the eyelids.

4. If the drainage persists, call your doctor for further recommendations.

Drainage from a blocked tear duct is different from typical drainage from “pink eye.”  The drainage will reoccur as long as the duct is blocked.  It is similar to having a clogged drain in a sink that is being filled with dirty dishes.  The natural bacteria around the eyelashes and skin collect the “backed up” watery tears causing the drainage.  Massaging the tear ducts effectively helps to “scoop out the dirty water” and the lid scrubs and antibiotics keep “the sink clean” until the blockage resolves.  Most tear duct blockages clear on their own by 12 months of age, but those that persist may need intervention by an ophthalmology specialist.  

You can view a printable version for reference offline here: Tear Duct Care.pdf