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Blocked Tear Duct in Babies: Signs, Massage Tips, and When to See a Doctor

January 22, 2026 Modified date: January 22, 2026

A blocked tear duct in a baby can look dramatic—constant watering, sticky lashes, and a crusty inner corner—yet it is often a temporary plumbing problem rather than an eye infection. Most cases happen because a thin membrane at the end of the drainage system has not opened fully at birth. The reassuring part is that many infants improve on their own over the first months of life, especially with gentle home care and (when advised) tear-duct massage. The important part is knowing when the pattern is typical and when it is not. Redness, swelling near the nose, fever, or a baby who seems unwell can signal an infection that needs medical attention. This guide explains what to look for, how to massage safely, how to clean discharge without irritating the skin, and what treatment options exist if the blockage persists beyond infancy.

Top Highlights

Many blocked tear ducts improve spontaneously in the first year, and simple home care can ease symptoms.
Proper lacrimal sac massage can help clear mucus and may support earlier resolution when done correctly.
Antibiotic drops are not always needed and should be used only when a clinician suspects infection.
Urgent care is needed for swelling at the inner corner, increasing redness, fever, or a baby who appears unwell.
A consistent routine of cleaning and massage (when recommended) is usually more effective than frequent product changes.

How to tell if it is a blocked tear duct
Why blocked tear ducts happen in babies
How to do tear duct massage safely
How to clean discharge and protect the skin
When to see a doctor and when it is urgent
What happens if it does not clear

How to tell if it is a blocked tear duct

A blocked tear duct in a baby is also called congenital nasolacrimal duct obstruction. You may hear “dacryostenosis,” which simply means the tear drainage pathway is narrowed or closed. The typical pattern is watering plus stickiness, often without the deep redness you would expect from true conjunctivitis.

Common signs parents notice include:

Constant tearing in one or both eyes, even when your baby is not crying.
Sticky discharge that collects at the inner corner or crusts on the lashes after sleep.
Watery overflow that runs onto the cheek and irritates the skin.
Intermittent “gunky” flare-ups that come and go, especially during colds.
One eye worse than the other (very common).

A useful clue is that the white part of the eye often looks mostly normal. The eye may look wet and messy, but not intensely red. If you gently wipe away discharge, the eye surface itself can appear calm.

Blocked tear duct vs conjunctivitis

Parents often worry about “pink eye.” Consider these distinctions:

Blocked tear duct: tearing and discharge, usually mild redness at most, often one-sided, tends to be present from early weeks and can persist.
Conjunctivitis: more noticeable redness across the white of the eye, irritation, and sometimes swelling of the eyelids. Discharge can be watery (viral) or thick (bacterial).

Blocked tear duct vs congenital glaucoma

This is less common, but it matters because it is urgent. Seek prompt evaluation if your baby has:

Strong light sensitivity
A cloudy-looking cornea
Enlarging eye appearance
Excessive tearing with marked fussiness

A quick home observation that helps

When discharge builds up, some parents notice it returns quickly after cleaning. That recurrence is typical when tears are not draining well. You might also see a small pool of tears at the lower lid margin.

If you are uncertain, take a clear photo in good light and note when symptoms started. Clinicians often diagnose this condition based on the pattern and a simple exam. The goal is not perfect certainty at home; it is recognizing the typical features and watching for the exceptions that need medical care.

Why blocked tear ducts happen in babies

Tears are meant to wash across the eye and then drain through tiny openings in the eyelids (puncta) into a small channel and a tear sac, then down a duct into the nose. In many newborns, the final opening into the nose is still covered by a thin membrane. When that membrane does not open right away, tears and normal eye surface mucus can back up and spill over the lids.

The most common reason

The classic cause is a membrane at the end of the duct that remains closed after birth. This is why symptoms often begin in the first weeks or months, around the time tear production becomes more robust.

Why it can look worse during colds

Even a mild cold can swell the lining inside the nose. Because the tear duct drains into the nose, nasal congestion can make drainage slower. Many parents describe a pattern like this:

Symptoms are mild most of the time
Discharge increases during respiratory infections
Things improve again as the cold resolves

One eye or both

Blocked tear ducts can affect one or both eyes. One-sided symptoms are common and do not necessarily mean the other eye will develop the same problem.

What discharge actually means

A small amount of yellow-green discharge can appear even without a true eye infection. When tears sit in the tear sac and duct, bacteria that normally live on skin can multiply, leading to stickiness. This can look like infection but may be more like “stagnant drainage.” That is why cleaning and massage can improve symptoms without antibiotics in many cases.

How long it usually lasts

Many infants improve within the first year of life. For most families, the practical timeline looks like:

Early months: watery eye and intermittent crusting
Middle months: gradual improvement, often with fewer “gunky” mornings
By around a year: many babies are much better or resolved

This natural tendency to improve is why initial management is usually conservative unless red flags appear.

When the cause may be different

Less commonly, a baby may have an anatomical issue such as punctal narrowing, canalicular problems, or nasal variations that reduce drainage. Clinicians consider these possibilities when:

Symptoms are severe and persistent
There are repeated infections
The pattern does not improve with time
The exam suggests something beyond a simple distal membrane

Understanding the “why” helps you choose the right approach: gentle care, consistent technique, and a clear plan for when to escalate—rather than cycling through drops or home remedies without direction.

How to do tear duct massage safely

Tear duct massage is often called lacrimal sac massage or the Crigler massage technique. The idea is not to rub the eyeball. It is to apply gentle, targeted pressure over the tear sac area to help express trapped mucus and encourage drainage. Done well, it can reduce discharge and may support earlier resolution in some infants.

Before you start: safety basics

Wash your hands thoroughly.
Keep nails short and avoid jewelry that could scratch.
Use a calm moment—after a feeding or bath often works well.
If your baby becomes very distressed, pause and try later; consistent gentle attempts are better than a struggle.

Finding the right spot

The tear sac sits near the inner corner of the eye, close to where the eyelids meet beside the nose. A helpful landmark is the small area just between the inner corner and the bridge of the nose.

Step-by-step massage technique

A commonly recommended approach is:

Place your fingertip at the inner corner of the eye, just beside the nose.
Apply firm but gentle pressure (enough to move the skin, not enough to cause pain).
Make a short downward stroke along the side of the nose.
Repeat for a small set of strokes (for example, several strokes in a row).
Stop if the area becomes increasingly red, swollen, or tender.

During massage, you may see mucus express into the corner of the eye. That is not dangerous; it is often the point. Wipe it away gently after you finish.

How often should you do it

Families are often advised to do massage a few times per day, with a small set of strokes each time. The exact schedule can vary by clinician preference and the baby’s tolerance. The most important factor is consistency: a simple routine you can keep.

If your clinician gives you a specific plan, follow that plan. If you have not yet been evaluated, use a conservative approach and avoid overly forceful pressure.

What not to do

Do not press directly on the eyeball.
Do not use cotton swabs aggressively in the inner corner.
Do not use essential oils, herbal drops, or breast milk in the eye. These can irritate tissue and increase infection risk.

When massage should be paused

Stop massage and seek medical advice if you notice:

Swelling, warmth, or increasing redness at the inner corner near the nose
A firm tender lump in that area
Fever or a baby who seems ill
Rapidly worsening discharge with eyelid swelling

Massage is meant to be a low-risk home strategy. If it becomes painful or the area looks infected, the priority shifts to medical evaluation.

How to clean discharge and protect the skin

The day-to-day challenge with a blocked tear duct is not usually the tears themselves. It is the cycle of wet cheeks, sticky lashes, and irritated skin. Gentle cleaning keeps your baby comfortable and reduces the chance that mucus buildup becomes a bigger problem.

A simple cleaning routine

Most families do well with a straightforward approach:

Use clean cotton wool or a soft pad moistened with clean water (warm, not hot).
Wipe from the inner corner outward in one smooth motion.
Use a fresh pad for each wipe and each eye to avoid spreading bacteria.
Clean as needed, especially after sleep and before massage.

If lashes are stuck together, hold the warm moistened pad over the area briefly to soften crusts. Avoid scraping; gentle soaking prevents skin breakdown.

Keeping the skin from getting sore

Constant tearing can cause redness and chapping on the cheek and under the lower lid. Practical ways to protect the skin include:

Pat the area dry after cleaning rather than rubbing.
Use a thin protective barrier on the cheek if the skin is breaking down, especially before sleep.
Keep drool and milk residue off the area, since they can add irritation.

If you use any barrier product, keep it away from the eyelid margin and eye surface. The goal is to protect skin, not coat the eye.

When are antibiotic drops helpful

Antibiotic drops are typically used when a clinician suspects conjunctivitis or secondary infection, such as:

Increased redness of the white of the eye
Eyelid swelling
Thick discharge that is worsening rather than stable
A baby who seems uncomfortable or unwell

It is common for parents to request drops because discharge looks “infected.” However, stagnant tears alone can look yellow. This is why clinicians often focus on the overall picture rather than the color alone.

Daycare and “contagious” concerns

A blocked tear duct itself is not contagious. If the eye is not significantly red and your baby otherwise seems well, many families continue normal activities. If a clinician diagnoses conjunctivitis, follow their guidance for daycare and hygiene.

What to avoid

Avoid “whitening” drops or adult eye products.
Avoid antiseptics near the eye.
Avoid frequent switching among wipes, soaps, and topical products, which can worsen irritation.

The comfort goal

You are aiming for a routine that is gentle, repeatable, and doesn’t inflame the skin:

Clean when needed
Massage if advised
Protect the cheek if it is chapped
Watch for signs that the problem is changing

When families keep the routine simple, many notice the eye looks less sticky overall—even before the duct fully opens—because the tear film stays cleaner and the skin stays intact.

When to see a doctor and when it is urgent

Most blocked tear ducts can be managed initially with home care and routine follow-up, but certain findings should move you from “watch and wait” to “get seen.” The safest approach is to separate routine questions from urgent warning signs.

When a routine visit is appropriate

Consider booking a standard appointment with your pediatrician or an eye clinician if:

Tearing and discharge persist beyond the early months and you want a clear plan.
You are unsure whether it is a blocked duct or conjunctivitis.
Symptoms are mild but ongoing, especially if only one eye is affected.
Your baby has recurrent flare-ups during colds and you want guidance.
You want a demonstration of massage technique to ensure you are doing it correctly.

A routine visit can confirm the diagnosis, rule out uncommon look-alikes, and prevent unnecessary antibiotic use.

Red flags that need prompt medical evaluation

Seek urgent care the same day if you notice:

Swelling, redness, and tenderness at the inner corner near the side of the nose
A puffy, firm lump in that area
Fever, poor feeding, unusual sleepiness, or a baby who looks generally unwell
Rapidly increasing eyelid swelling
Significant redness of the eye surface with discomfort

These signs can suggest dacryocystitis, an infection of the tear sac. This is not a “wait it out” situation; it can worsen quickly and may require systemic antibiotics and close monitoring.

When to think beyond a blocked tear duct

Ask for prompt assessment if you notice any of the following:

A cloudy-looking eye or strong light sensitivity
The eye looks unusually large or your baby seems very uncomfortable with tearing
Persistent tearing with marked redness that does not improve
Symptoms that begin right after trauma to the eye area

Clinicians may look for conditions such as congenital glaucoma, corneal issues, eyelid malposition, or infection unrelated to the tear duct.

What to expect at the visit

A clinician may:

Examine the eyelids and inner corner area
Look at the eye surface for conjunctivitis or irritation
Assess the cornea for clarity
Ask about timing, discharge pattern, and prior treatments
Decide whether conservative care is appropriate or whether referral is needed

A practical decision rule for parents

If your baby’s eye is watery and sticky but your baby is otherwise well, the white of the eye is mostly normal, and there is no inner-corner swelling, you can usually manage at home while arranging routine advice. If there is swelling near the nose, fever, or a baby who seems ill, treat it as urgent.

Trust your instincts about your baby’s overall behavior. A blocked duct alone is annoying; infection tends to make babies look and act different.

What happens if it does not clear

When a blocked tear duct persists, parents often worry they “missed the window” or did something wrong. In reality, persistence is usually about anatomy and timing, not parenting. If symptoms continue, clinicians shift from conservative care to procedural options based on the baby’s age, symptom severity, and infection history.

Typical timeline for escalation

Many clinicians start with conservative care for much of the first year because spontaneous resolution is common. Escalation is considered when:

Symptoms remain significant as your baby gets older
Discharge and tearing are persistent and bothersome
There are repeated infections or episodes concerning for tear sac involvement
The blockage interferes with comfort, skin health, or quality of life

The exact timing varies. The decision is individualized and often depends on how frequently the eye is inflamed and how disruptive symptoms are for the child and family.

Probing and irrigation

The most common next step is nasolacrimal duct probing, often paired with irrigation. In simple terms, a small probe is passed through the drainage pathway to open the obstruction. Key points parents should know:

It is usually a brief procedure.
It may be done in an office setting for selected cases or under anesthesia depending on age, cooperation, and local practice.
Success rates are generally higher in uncomplicated cases and can be influenced by age and whether the obstruction is simple or complex.

When additional tools are used

If probing does not resolve the problem or if the obstruction is complex, clinicians may consider:

Silicone tube intubation, where a small soft tube helps keep the pathway open during healing.
Balloon dacryoplasty, which uses a small balloon to widen the duct in selected cases.

These approaches are typically discussed when first-line probing is not enough or when the anatomy suggests a higher chance of persistence.

What parents can do while deciding

If you are approaching the point where a procedure is being discussed, it helps to bring a few details to the conversation:

How often the eye is sticky or crusted
Whether colds trigger major flares
Whether there have been episodes of inner-corner swelling
What you have tried (cleaning routine, massage frequency, any prescribed drops)
Any history of prematurity or craniofacial differences that might affect anatomy

Reassurance about long-term outcomes

For most children, the outlook is excellent. Persistent blockage is usually treatable, and clinicians aim to choose the least invasive option that fits the child’s age and symptoms. The main risk of doing nothing indefinitely is not typically “eye damage” from tearing alone; it is recurrent infection and ongoing discomfort.

If your baby’s symptoms are persistent, the best next step is not endless trial-and-error at home. It is a clear plan with an experienced clinician: what to watch for, what timeline to follow, and what procedure would be considered if the duct does not open on its own.

References

Disclaimer

This article is for educational purposes only and does not provide medical advice, diagnosis, or treatment. A watery, crusty eye in a baby is often caused by a blocked tear duct, but similar symptoms can occur with conjunctivitis and, less commonly, urgent eye conditions. If your baby has swelling or tenderness near the inner corner of the eye, fever, rapidly worsening redness, significant eyelid swelling, a cloudy-looking eye, marked light sensitivity, or appears unwell, seek urgent medical evaluation. Always follow guidance from your pediatrician, optometrist, or ophthalmologist for diagnosis and treatment decisions.

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