Ocular discharge, often called “gunk,” is a common occurrence in infants that frequently concerns new parents. This discharge can range from clear and watery to thick and crusty, indicating issues with the eye’s natural drainage and cleaning systems. While the sight of sticky eyes can be alarming, the causes are often benign and resolve without intensive medical intervention. Understanding the source of the discharge is the first step in determining the correct course of action, which may involve simple home care or a visit to a pediatrician.
Blocked Tear Ducts
The most frequent non-infectious cause of eye discharge in infants is a condition known as dacryostenosis, or a blocked tear duct. Tears are produced in the lacrimal gland and normally drain through small openings in the inner corner of the eyelids into the nasolacrimal duct, which leads into the nose. In many newborns, the thin membrane covering the end of this duct, called the Valve of Hasner, fails to open fully at the time of birth, preventing tears from draining properly.
This blockage causes tears to pool on the eye’s surface, leading to constantly watery eyes, a symptom known as epiphora. The stagnant fluid can sometimes become mixed with normal mucus and skin oils, resulting in a thin, white, or slightly sticky discharge that often crusts over the eyelashes and inner corner of the eye, particularly after sleep. The eye itself typically remains white and free of redness, which helps distinguish this issue from an infection. The condition is self-resolving in the majority of infants, often by the time they reach 1 year of age, as the pressure from tears helps to push the membrane open.
To encourage the duct to open, a gentle technique called the Crigler massage is often recommended. This technique involves placing a clean finger on the outside of the nose, next to the inner corner of the eye, and applying firm but gentle pressure. The pressure is then directed downward toward the cheek to help increase hydrostatic pressure in the lacrimal sac. This non-invasive method aims to expedite the natural opening process and is generally considered the first line of treatment.
Infectious Causes
Eye discharge caused by an infection, primarily conjunctivitis or “pink eye,” presents with distinct symptoms that differentiate it from a blocked duct. Conjunctivitis involves inflammation of the conjunctiva, the clear membrane covering the white part of the eye and the inner surface of the eyelids. The presence of thick, pus-like discharge that is yellow or green is a strong indicator of a bacterial infection, which tends to cause the eyelids to stick together, especially after a nap.
Unlike a simple blocked duct, infectious conjunctivitis typically presents with redness of the white part of the eye, puffiness of the eyelids, and sometimes increased tenderness. Viral forms, often accompanying a common cold, may produce a more watery discharge with a pink or red eye. Bacterial forms require a medical assessment for a potential course of antibiotic drops or ointment. Neonatal conjunctivitis, a form acquired during birth, can be particularly serious and may be caused by bacteria like Chlamydia trachomatis or Neisseria gonorrhoeae, requiring prompt and specific treatment, often with oral antibiotics.
Safe Cleaning and Home Care
Regardless of the underlying cause, safely and regularly cleaning the discharge from the eyes is an important part of home care to prevent the discharge from hardening and causing irritation. Before touching the baby’s eye area, caregivers should always wash their hands thoroughly with soap and water to prevent introducing bacteria. The cleaning material should be sterile, such as a clean cotton ball, cotton pad, or a soft piece of gauze, moistened with cooled, previously boiled water or sterile saline solution.
The proper technique involves wiping gently across the eye, starting from the inner corner near the nose and moving outward toward the ear. This wiping direction moves the discharge away from the nasolacrimal drainage system. Use a fresh, clean wipe or a new section of the cloth for each single swipe. It is important to use a completely separate wipe for the other eye, even if only one eye is affected, to avoid cross-contamination.
When to Seek Medical Attention
While many cases of ocular discharge in infants are related to a blocked tear duct and resolve spontaneously, certain signs necessitate immediate consultation with a pediatrician or eye specialist. Any discharge accompanied by significant redness of the white of the eye or swelling of the eyelids should be evaluated, as these symptoms suggest an infection that may require prescription treatment.
Parents should also seek medical advice if the discharge is thick, yellow, or green and persists despite regular cleaning, or if the baby develops a fever alongside the eye symptoms. Other red flags include light sensitivity, excessive pain or discomfort indicated by constant eye rubbing or fussiness, or if the skin around the eye appears red, swollen, and tender, which could signal a spreading infection like dacryocystitis. If the symptoms of watering and discharge do not improve with home care by the time the child reaches one year of age, a specialist referral may be warranted.