Watery eyes in infants, medically known as epiphora, is a frequent concern for new parents. This symptom refers to the overflow of tears onto the cheek, even when the baby is not crying. Infants are prone to this issue because their tear drainage system is still developing after birth. Understanding the reason behind the constant tearing can help guide parents on the appropriate next steps.
The Most Common Culprit: Blocked Tear Ducts
The most frequent reason for a baby’s persistently watery eye is congenital nasolacrimal duct obstruction, or a blocked tear duct, affecting about 6% of newborns. Tears normally drain through the nasolacrimal duct into the nose. In infants, a thin membrane often fails to open fully, causing tears to back up and spill over the eyelid.
This blockage causes excessive clear tearing, often in just one eye, sometimes accompanied by mild stickiness or crusting on the eyelashes after sleep. The condition is not contagious and usually resolves spontaneously; about 90% of cases clear by the time the child reaches one year of age.
While waiting for the duct to open naturally, the Crigler massage can help promote drainage. First, thoroughly wash your hands. Place the tip of your index or pinky finger on the tear sac, located in the inner corner of the eye next to the nose bridge. Press firmly and roll the finger in a downward stroking motion along the side of the nose. This technique should be repeated three to five times, multiple times a day, often recommended at every diaper change.
Wateriness Caused by Infection
When a watery eye is accompanied by discharge and redness, an infection is a likely cause. Conjunctivitis, or pink eye, is inflammation of the clear membrane covering the eye and inner eyelid, caused by a virus, bacteria, or allergy.
Viral conjunctivitis often accompanies a cold and produces a profuse, watery discharge, usually affecting both eyes. Bacterial conjunctivitis is characterized by a thicker, yellow or green discharge that causes the eyelids to stick together upon waking. Diffuse redness across the conjunctiva differentiates infection from a simple blocked duct.
Infectious conjunctivitis is highly contagious, requiring strict hygiene to prevent spread. Frequent hand washing is necessary after touching the baby’s eyes or face. Use separate towels and washcloths to avoid transmission to other family members.
Irritants and External Factors
Sometimes, a baby’s watery eyes are a temporary reaction to the environment. External factors cause the eyes to produce reflex tears as a protective response to wash away the irritant.
Common airborne irritants include household smoke (from cigarettes or fireplaces), dust, pet dander, and strong fumes from cleaning products. Exposure to wind or cold air can also temporarily stimulate tear production. While seasonal allergies are less common in very young infants, they become a more frequent cause as children get older, leading to watery eyes often accompanied by itching. These symptoms typically resolve quickly once the baby is removed from the triggering environment.
Warning Signs and When to Call the Doctor
While most causes of watery eyes in babies are common and benign, certain accompanying symptoms require a prompt evaluation by a healthcare provider. These “red flag” signs suggest a more serious condition, an infection requiring medication, or a complication of a blocked duct.
Contact your pediatrician immediately if you observe any of the following symptoms:
- Colored Discharge and Swelling: If the discharge becomes thick, yellow, or green, or if the eyelids are noticeably swollen, this may indicate a bacterial infection like conjunctivitis or dacryocystitis (an infection of the tear duct sac).
- Light Sensitivity (Photophobia): An extreme aversion to light, where the baby squints or cries when exposed to normal lighting, can be a symptom of a condition like congenital glaucoma, which needs urgent attention.
- Corneal Clouding: If the clear part of the eye, the cornea, appears hazy, cloudy, or white, this represents a serious ocular issue.
- Redness or Tenderness: Look for redness or a tender, warm lump near the inner corner of the eye next to the nose, which suggests a severe infection of the tear sac.
- Other Systemic Symptoms: A watery eye accompanied by a fever, lethargy, or if the baby appears to be in pain, should be addressed by a doctor right away.