HWN Suggests

What’s that gunk in my newborn’s eye?

Gunk…not exactly a medical term, but a descriptive one nonetheless. Any parents out there reading this are probably familiar with the following scenario. After the trauma of childbirth (for mom, that is), you feel so blessed to hold your child close and the first thing you do is make sure everything on him/her is perfect. Then, a day or two later, you may notice that there’s a lot of mucus in your infant’s eye, maybe even so much to cause it to stick shut. The eye is constantly wet with tears. Is it an infection? Do you need antibiotics?

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 Nasolacrimal Duct Obstruction

Nasolacrimal DucNot all matted lashes are due to conjunctivitis! Think about clogged tear ducts and recommend gentle massage.t Obstruction (NLDO) is the most common lacrimal system problem.

Articles of Interest

Crigler Massage for Congenital Blockade of Nasolacrimal Duct

Congenital NLDO is a common problem in almost 5% of infants, which resolves spontaneously with Crigler massage in a high success rate. Probing or surgical procedures should not be considered prematurely before 6 months of age.

Eye: Tear Duct Massage

Press firmly and move your index finger in short downward strokes 3 to 5 times. Repeat these steps 3 times a day: morning, noon and night.

Nasolacrimal Duct Obstruction in Children

Approximately 5% of infants have some symptoms of NLDO (nasolacrimal duct obstruction). It is usually caused by persistence of a membrane at the distal valve of Hasner. The primary symptoms are epiphora, which result from backflow of tears due to blockage of the duct, and periocular crusting and discharge due to infection of the lacrimal system (Figure 1). This dacryocystitis in infants with NLDO is typically low grade, and the organisms are usually normal flora.

When Tear-Producing and Tear-Drainage Systems Malfunction

Besides having tears heavily produce or constantly flow, some patients’ eyes may produce excessive mucus. Pain or irritation may or may not accompany this symptom.

Resources

AAPOS

Over 5% of infants have clinical symptoms of nasolacrimal duct obstruction affecting one or both eyes. Most (approximately 90%) clear spontaneously during the first year of life.

StatPearls

Nasolacrimal duct obstruction (NLDO) or dacryostenosis is the most common disorder of the lacrimal system, and approximately 6 to 20 percent of newborns exhibit symptoms of this condition. Typically, NLDO presents in the first weeks or months of life with symptoms that begin when normal tear production starts, presenting with excessive tearing and ocular discharge.