Children with sticky and watery eyes due to failure of tear drainage

Introduction

This leaflet is designed to give parents/ carers of children with sticky and watery eyes information about the disorder and its treatment. The most common cause of sticky, watery eyes is delayed development of the naso-lacrimal duct that connects the tear sac with the nose.

In small babies this is a very common problem with up to 20% of babies (1 in 5) having some of the symptoms. In the great majority of babies with watery, sticky eyes, these symptoms will improve during the first few months of life. Symptoms will have resolved in more than half of all affected babies by eight months and in 95% by one year of age. It is only in the small number of babies with symptoms persisting beyond one year of age that we might suggest surgical treatment.

What you can do at home

If your child is getting a lot of sticky discharge from his/ her eye(s) during the day, you can help by massaging the tear sac: roll your little finger firmly just between the inside corner of the eye and the nose for a minute while your baby is breast or bottle feeding. This may release the discharge from within the tear sac and this can then be cleaned away. Crusty discharge on the lashes and lids can also be cleaned using a clean tissue soaked with cooled boiled water. Antibiotic drops and ointments are thought to make little difference, unless the eye becomes red and very sticky.

If the skin of the lower eyelid is getting sore because of the overflow of tears, it can be helpful to rub a little petroleum jelly on the affected skin with a fingertip. This waterproofs the skin and makes it easier to clean any crusts off.

Surgical treatment

After 12 months of age, if the problem does persist, the chances of it clearing up without treatment are reduced and many parents will consider that it is time for something to be done, especially if the eye has been very sticky as well as watery.

Surgical treatment is the passage of a fine probe through the tear passages to break down any obstructions. This is done as a day case and involves a short general anaesthetic.

Like all anaesthetics, this carries a very small risk of serious complications, but the procedure produces a rapid and complete cure in about 75% (3 in 4) cases. Even if it does not produce a cure, the findings will indicate what further treatment is required. There are no scars or stitches.

Alternatives

Waiting longer is an alternative, especially if the symptoms do not seem so severe, as some one year old children can still get better without treatment. About 60% (6 in 10) of all those who still have the problem on their first birthday are free of symptoms by the time they are two, and most of these settle by the time they are 18 months old.

The advantage of this option is that it may avoid an operation, but there is also a disadvantage. Of those children who are still not better at two, about 50% (1 in 2) will respond at once to a probing, and have therefore simply had their treatment delayed. However, there is no good evidence to suggest that delaying treatment reduces the success if a probing is in the end needed and some children even get better after their second birthday without treatment.

Your doctor will discuss these choices, and any special issues in relation to your own child, to help you decide on the treatment you want.

Further information

• Patient Info (opens in a new tab)
• Eye wiki (opens in a new tab)

Hospital contacts

Consultant paediatric ophthalmologist

Department of Ophthalmology,
Clinic 3,
Box 41,
Addenbrooke’s Hospital,
Cambridge University Hospitals NHS Foundation Trust,
Hills Road,
Cambridge,
CB2 0QQ

Telephone: 01223 245151 (Switchboard)

Secretary: 01223 216700

Paediatric ophthalmology nurses

Department of Ophthalmology,
Clinic 3,
Box 41,
Addenbrooke's Hospital,
Cambridge University Hospitals NHS Foundation Trust,
Hills Road,
Cambridge,
CB2 0QQ

Telephone: 01223 596414 (Monday – Friday 08:00 – 17:00hrs), 24-hour answer machine.