A newborn waking up with a crusty, sticky eye is common in the first few weeks of life. This symptom, often called “sticky eye,” is usually a benign issue that resolves as the baby develops. While seeing discharge and matting on the eyelashes can be concerning, most cases are not serious or indicative of a severe infection. Understanding the cause provides reassurance and guides appropriate care.
The Most Common Reason: Blocked Tear Duct
The most frequent reason for a newborn’s crusty eye is dacryostenosis, or a blocked tear duct, affecting about 6% of infants. Tears lubricate the eye and normally drain through the nasolacrimal duct, a channel running from the inner corner of the eye into the nasal cavity. If this duct is not completely open at birth, tears and mucus cannot drain properly.
This congenital blockage is often caused by the Valve of Hasner, a thin membrane at the end of the duct that fails to open fully. Since tears cannot flow into the nose, they back up onto the eye’s surface, collecting mucus and debris. This fluid then dries, resulting in the characteristic crusty discharge, especially after sleep.
Discharge from a simple blocked duct is usually clear or slightly yellowish mucus, and the white part of the eye (sclera) remains white and healthy. The condition often affects just one eye, though it can occur in both. Nearly 90% of these cases resolve spontaneously as the duct matures and opens, typically within the first year of life.
Safe Home Management
Gentle home management for a blocked tear duct focuses on clearing discharge and encouraging the duct to open. The first step is cleaning the eye to remove crusting and sticky residue. Use a clean cotton ball or soft washcloth moistened with warm water or a sterile saline solution.
Gently wipe the eye, moving from the inner corner near the nose toward the outer edge. Use a fresh, clean area of the cloth or a new cotton ball for each wipe to prevent spreading bacteria. This cleaning can be performed every few hours to keep the eye comfortable and clear of debris.
Tear duct massage, or Crigler massage, can also help open the blockage. To perform this, place your index finger against the side of the baby’s nose, next to the inner corner of the blocked eye. Apply gentle, firm pressure and stroke downward in a short motion three to five times, repeating this sequence three times a day. This pressure helps “milk” the stagnant fluid out and potentially open the duct membrane.
Identifying Signs of Eye Infection
While a blocked tear duct is the most common cause, stagnant tears can sometimes lead to a secondary infection, such as bacterial conjunctivitis (pink eye). Differentiating this from a simple blockage is important because the management differs. The key difference lies in the appearance of the eye itself, not just the discharge.
A blocked duct results in a watery eye with mucus, but conjunctivitis causes significant redness of the white part of the eye and the inner eyelid, indicating inflammation. Infectious discharge is often thicker, more pus-like, and may be distinctly yellow or green, accumulating rapidly after cleaning. The eyelids may also appear noticeably swollen or puffy.
Infections passed from the birth canal, known as ophthalmia neonatorum, are a serious form of bacterial conjunctivitis appearing within the first two weeks after birth. This infection presents with very red eyes, swollen eyelids, and abundant purulent discharge. A doctor must determine the specific cause of any suspected infection, as treatment involves antibiotic drops or, sometimes, oral antibiotics.
When Immediate Medical Care is Necessary
Certain symptoms warrant immediate consultation with a healthcare provider, suggesting a more serious condition than a simple blockage. Severe swelling of the eyelids that prevents the baby from opening their eye is a red flag. Persistent, intense redness of the white of the eye or surrounding skin also signals that an infection is worsening or has spread.
Seek prompt medical attention if the discharge is profuse, constantly recurring immediately after cleaning, or if you notice a firm, red, and tender lump near the inner corner of the eye. This lump may signal a deeper infection of the tear sac. Any signs of systemic illness accompanying the crusty eye, such as a fever, lethargy, poor feeding, or extreme irritability, require immediate evaluation.