A baby’s watering eye is a common concern for parents. While excessive tearing can signal an issue, in infants, it often points to a highly treatable, non-serious condition. Understanding the source is the first step toward providing appropriate care and determining if medical intervention is needed. This article explores the most frequent causes, distinguishes between blockages and infections, and details home care steps that can offer relief.
Understanding Blocked Tear Ducts
The most frequent reason an infant’s eye waters is dacryostenosis, or a blocked tear duct. Tears are produced in the lacrimal glands and drain through the nasolacrimal duct into the nose. In approximately 5 to 20 percent of newborns, a thin membrane at the end of this duct, called the Valve of Hasner, fails to open fully at or shortly after birth, preventing proper drainage.
When this drainage pathway is obstructed, tears collect and spill onto the cheek, leading to a persistent wet appearance, even when the baby is not crying. The eye itself typically remains clear and white, which distinguishes this from an infection. A blocked duct may also cause slight stickiness or crusting on the eyelashes and inner corner of the eye, particularly after the baby wakes up.
This condition often affects only one eye, but it can occur bilaterally. The duct naturally continues to develop and open after birth. The vast majority of cases, about 90 percent, resolve spontaneously without intervention within the first year of life as the drainage system matures.
Identifying Infection and Irritation
While a blocked duct is common, persistent tearing combined with other distinct symptoms may indicate an infection or external irritation. The most well-known infectious cause is conjunctivitis, commonly called pink eye, which can be bacterial, viral, or allergic. The key difference from a simple blockage is the presence of significant redness across the white of the eye and the inner eyelid.
Bacterial conjunctivitis is characterized by a thick, purulent discharge that is yellow or green, often causing the eyelids to stick together, especially after sleep. Viral conjunctivitis tends to produce a more watery discharge and may accompany symptoms of an upper respiratory infection. For either type, the underlying cause is inflammation of the conjunctiva, the clear membrane covering the eye and inner eyelid.
Irritation is another cause of excessive tearing, though it is usually temporary. Exposure to environmental factors like dust, smoke, or strong chemicals can trigger a protective tear response. Unlike infections or blockages, this watering is typically sudden, and the eyes will quickly return to normal once the irritant is removed.
Safe Home Care Techniques
For a baby diagnosed with a blocked tear duct or mild irritation, home care focuses on maintaining cleanliness and encouraging the duct to open. Hand hygiene is important, so always wash your hands thoroughly before touching your baby’s eye area.
The eye should be gently cleaned several times a day to remove any pooled tears or discharge. Use a clean cotton ball or sterile gauze pad dampened with cooled, boiled water or a saline solution. Always wipe from the inner corner of the eye, near the nose, outward toward the ear to avoid pushing debris back into the duct opening.
A specific physical technique, known as lacrimal sac massage, can help clear the obstruction and is often recommended by pediatricians. To perform this, place your clean index finger near the inner corner of the eye, next to the side of the nose. Apply gentle but firm pressure and stroke downward three to five times, which helps “milk” fluid out of the duct. This massage can be repeated several times daily to encourage the membrane to open.
Warning Signs Requiring Immediate Medical Attention
Although most instances of a watering eye are manageable at home, certain signs require prompt professional evaluation. Parents should seek immediate medical attention if eye symptoms are accompanied by a fever, which can signal a more severe infection.
Severe swelling or redness that extends beyond the eyelid and onto the cheek or nose bridge is a serious red flag. Other concerning symptoms include any change in the eye’s appearance, such as cloudiness in the cornea, or extreme sensitivity to light (photophobia). Any thick, pus-like discharge that persists despite gentle cleaning should be evaluated quickly, especially if the baby appears to be in discomfort.