If your newborn has tears and pus, be careful of this congenital disease!

Newborn babies sometimes look very cute with tearful eyes. However, if the baby's eyes are always tearful when he is not crying, accompanied by increased eye secretions, eye mucus or even pus, you should pay special attention!

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1. Young children with long-term tearing and secretions should be alert to whether they have congenital nasolacrimal duct obstruction .

2. Congenital nasolacrimal duct obstruction is the most common cause of neonatal epiphora and has a certain degree of self-healing ability.

Children under 3.6 months old can receive conservative treatments such as lacrimal sac massage.

4. For children older than 6 months who do not respond to conservative treatment, lacrimal duct probing may be considered.

5. For children who have failed to probing the lacrimal duct multiple times, lacrimal duct catheterization or Hasner valvuloplasty can be performed.

6. Patients with complex lacrimal duct obstruction can undergo nasolacrimal cystostomy.

What is congenital nasolacrimal duct obstruction?

Congenital nasolacrimal duct obstruction is a common eye disease in children, with an incidence rate of 5%-20%. It usually occurs in one eye, and the most common site of obstruction is the end of the nasolacrimal duct and the opening of the nasal cavity (the end of the drainage system).

What are the symptoms?

The main manifestations of congenital nasolacrimal duct obstruction are excessive tearing and pus discharge. The naked eye can see a lot of secretions (eye boogers) in the child's eyes, and there is a thick layer of secretions and scabs on the eyelashes. Some children will have lumps in the lacrimal sac area (corners of the eyes) after acute infection, and have symptoms of redness, swelling, heat and pain.

What are the hazards?

1. Eczema around the eyes

Children's facial skin is delicate, and tears irritating the skin around the eyes can cause rashes, erosions, and itching that are difficult to heal over time.

2. Dacryocystitis

If the tear duct is blocked, tears will accumulate in the lacrimal sac, which is very likely to cause secondary infection and dacryocystitis, at which time purulent fluid will flow out. If not treated in time, the lacrimal sac and lacrimal duct mucosa will have an inflammatory reaction, making it easy for the tear duct to be blocked again after probing.

3. Tension epiphora

When the tear duct is blocked, tears, mucus and even pus will accumulate in the lacrimal sac for a long time, causing the lacrimal sac to lose its elasticity and tear drainage function. Even if the tear duct is unblocked, tension tears will occur due to the inability of the lacrimal sac to contract.

4. Keratitis

Once the cornea is slightly injured or the eyes are rubbed vigorously, the bacteria discharged from the lacrimal sac will invade the cornea and cause keratitis. Severe keratitis will leave permanent scars on the cornea and affect vision.

5. Orbital cellulitis

Bacteria can cause acute inflammation of the lacrimal sac, which can spread to surrounding tissues and cause orbital cellulitis and even life-threatening intracranial infection.

6. Aesthetic and psychological impact

The aesthetic and psychological impact of continuous tearing is obvious in older children. Children are often reluctant to raise their heads, look others in the eye or communicate with them, which leads to a decrease in self-confidence and a withdrawn personality.

How to treat it?

①Conservative treatment - lacrimal sac massage

Early detection can be treated with lacrimal sac massage. Place the index finger on the lacrimal sac area at the inner corner of the eye and massage from top to bottom along the direction of the nasolacrimal duct. By applying a certain amount of pressure to the nasolacrimal duct, the closed membrane tissue at the lower opening of the nasolacrimal duct is opened.

②Tear duct flushing or tear duct probing

For babies who do not respond to conservative treatment, if they are over 4 months old, they can go to the hospital's ophthalmology department for tear duct irrigation treatment.

If flushing is ineffective and symptoms have not improved, according to the doctor's advice, tear duct probing treatment can be considered to help open the blocked valve.

③ Lacrimal duct catheterization

It is often used in infants and older babies with failed lacrimal duct probing and complex nasolacrimal duct obstruction.

④ For babies who have not responded to lacrimal sac massage, lacrimal duct probing or lacrimal duct catheterization, or who have bony obstruction of the nasolacrimal duct or other developmental abnormalities and are unable to undergo the above treatments, minimally invasive surgery under nasal endoscopy is recommended if conditions permit.

How to determine whether the increase in child’s eye mucus is due to blocked tear ducts or other problems such as inflammation or heat?

The tear duct/eye and nose specialist at Wuhan University Aier Eye Hospital reminds parents that common inflammation will gradually improve after using anti-inflammatory eye drops. If the tear duct is blocked, the symptoms may disappear when taking the medicine, but recur once the medicine is stopped, or the secretions disappear but the tearing symptoms still exist. "If parents are worried, it is best to go to the hospital and ask the doctor for a diagnosis, and do not make judgments or use medicines on your own."