When a newborn’s eye is persistently watery and has discharge, parents often become concerned. This common finding, sometimes called “sticky eye,” is formally known as epiphora when referring to constant watering. Crusting results from tears and mucus pooling on the eye’s surface and drying overnight. This issue is frequent in newborns and usually does not indicate a severe problem, but attention is required to distinguish between a simple blockage and a possible infection.
Understanding Blocked Tear Ducts
The most frequent reason a newborn’s eye is watery and crusty is congenital nasolacrimal duct obstruction, or dacryostenosis. This occurs when the tear drainage system, the narrow passage leading from the eye to the nose, is blocked. Tears are produced in the lacrimal gland and normally drain through small openings in the inner corner of the eyelids, traveling down the tear duct to the nasal cavity.
In newborns, the blockage is typically caused by a thin membrane at the end of the tear duct that has not fully opened at birth. Since tears cannot drain properly into the nose, they build up on the eye’s surface, causing the eye to appear excessively wet. This stagnant fluid leads to the accumulation of mucus and discharge, which dries into crusting, especially after sleep. Dacryostenosis is a common and usually self-resolving condition, affecting around 6% of newborns.
Safe Cleaning and Massage Techniques
For simple dacryostenosis, parents can manage symptoms at home by keeping the eye clean and performing a specific massage technique. Always ensure hands are washed before touching the baby’s eye area. To clean the eye, use a soft, clean material like a cotton ball or pad moistened with sterile water or a saline solution.
The correct wiping technique involves gently sweeping from the inner corner of the eye outward toward the ear. This motion prevents discharge from being pushed back into the tear duct openings. Use a fresh cotton ball for each wipe to prevent transferring discharge back to the eye or to the other eye if both are affected.
Lacrimal Sac Massage
The lacrimal sac massage, sometimes called the Crigler massage, can help open the duct by applying pressure. Use the tip of your index finger to apply gentle but firm pressure to the skin next to the inner corner of the eye, where the tear duct system begins.
Stroke or roll the finger downward, toward the nose, about three to five times. This action is intended to increase pressure within the tear duct, which may help push open the membrane obstruction at the lower end.
Recognizing Signs of Eye Infection
While most crusting is due to simple blockage, parents must recognize signs suggesting a bacterial infection (conjunctivitis) or a localized tear duct infection (dacryocystitis). A key differentiator is the appearance of the conjunctiva; if the white part of the eye appears red or pink, it suggests inflammation or infection beyond a simple blockage. The discharge from a blocked duct is usually clear or whitish mucus, but an infection typically produces thick, yellow or green pus.
Significant swelling of the eyelids or puffiness around the eye also points toward an infection. With dacryocystitis, a tender, firm, and often red lump may develop at the inner corner of the eye, near the nose. When a bacterial infection is present, the discharge is often copious, causing the eyelids to stick together quickly after cleaning.
When to Seek Medical Attention
Contact your pediatrician promptly if you observe signs of infection, such as significant redness of the white of the eye, thick yellow-green discharge, or swelling. Immediate medical attention is necessary if your baby develops a fever alongside the eye symptoms, or if a hard, red lump appears near the inner corner of the eye, indicating a deeper infection.
If watery and crusty eye symptoms persist without signs of infection, consult your doctor even if home care has been applied diligently. A medical evaluation is necessary if the tear duct remains blocked and symptomatic after the child reaches about one year of age. At this point, an eye specialist may recommend further intervention.