Blocked tear ducts: Should my baby have a probing procedure?- Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the FactsYour options- Have a probing procedure to open your baby's
blocked tear duct if your baby is 6 months to 1 year old.
- Wait
until your baby is 1 year old to see if the blocked tear duct opens on its own.
If it doesn't open, you can decide about the procedure then.
Key points to remember- Most
blocked tear ducts open on their own by the time a
baby is 1 year old. Probing may be recommended if:
- Your baby is almost 12 months old and the
tear duct is still blocked.
- Your baby has a bluish, bulging area
alongside the nose.
- Your baby becomes more fussy and cranky
because of blocked tear ducts.
- If your baby is 6 to 12 months old and has had
many eye infections, there may be too much scarring for the duct to open on its
own. But this is rare.
- A rare risk from probing is scarring of the eye's drainage
system. This may make it harder to open the tear duct if the procedure has to
be done again.
- A blocked tear duct doesn't hurt your baby's
vision. Waiting to have the procedure, or not having it at all, won't hurt your
child's ability to see.
- When or if to have probing is partly a
personal decision. If you don't like the way a blocked tear duct makes your
baby look or if you have a hard time keeping his or her eye clean, you may want
to think about probing.
FAQsWhat should you know about probing? The probing
procedure to open a blocked tear duct is usually not done in a baby younger
than 6 months of age. It is used to clear simple blockages. These can happen
when the thin tissue that covers the opening at the end of the tear duct does
not open at or near birth. Probing is usually done in a hospital
using
general anesthesia. It may take several
days for a baby to heal after probing has been done. Sometimes
probing needs to be done again. So 6 weeks after surgery, your doctor will
check the tear duct to see if it is still blocked. If it is, massage and
antibiotics are used for 4 to 6 more weeks. If your
baby still has too much tearing, the probing procedure is done again. When
there is too much tearing, the eye may appear moist or wet with or without
drops flowing down the face. Symptoms may come back for a short
time after probing is done if your child gets a sinus infection or a
cold. How well does probing work? Probing opens the duct
in about 90 out of 100 babies who have blocked ducts.1
This means that it doesn't open the duct in 10 out of 100 babies. But most
blocked tear ducts go away on their own by a baby's first birthday. If a
child's tear duct has not opened by the time he or she is 12 to 13 months old,
probing is usually done. One study of older children with blocked
tear ducts showed that probing worked for:2 - 89 out of 100 children who were probed at age 2.
- 80
out of 100 children probed at age 3.
- 71 out of 100 children probed
at age 4.
- 42 out of 100 children probed at age 5.
Most of the time, probing works well to clear simple
blockages. When blockages are more complicated, probing works about half the
time. What are the risks of probing? A probing procedure
has the same risks as surgery, such as infection, bleeding, and risks of
anesthesia. - Children usually need
general anesthesia to keep them perfectly still during
the procedure. It has greater risks than
local anesthesia.
- Local anesthesia has few
or no risks, but the pain control is not as good. Also, babies need to be
restrained to keep them very still during the procedure. Local anesthesia is
not advised for babies 1 month of age or older.
With probing, there is a rare risk of scarring of the
drainage system between the eye and the nose. This can cause a blockage of its
own. If this happens, the duct may be hard to open if probing is done again.
What are the risks of delaying or not having probing? The risks of delaying or not having a probing procedure to open a blocked
tear duct are low in young babies. - Very rarely, babies can get serious
infections around the eye from blocked tear ducts. These infections occur
because tears build up behind the blocked duct and allow bacteria to
grow.
- Also rarely, repeat infections from blocked tear ducts may
cause scarring of the tear duct. This is usually fixed by probing.
Even with a blocked tear duct, your child can still see.
Delaying or not having probing won't hurt your child's vision. Why might your doctor recommend a probing procedure to open blocked tear ducts? Your doctor may recommend probing if: - Your child has turned 1 year old and still
has a blocked tear duct.
- Your child has had repeated eye
infections. These can cause scarring that can make the duct unlikely to open on
its own.
- Your child has a bluish, bulging area alongside the
nose.
- Your baby has become more fussy and cranky because of the
blockage.
2. Compare Options| | Schedule probing for
your baby | Wait to see if the duct
opens on its own |
|---|
| What is usually involved? | - Probing is done in a hospital. Your baby will have general
anesthesia.
- Healing takes several days. Often after probing, you will need
to give your baby
antibiotic eyedrops 4 times a day for 1 week.
- Symptoms may come back after probing if your child gets an
infection or cold.
- Your baby's doctor will check the duct 6 weeks
after probing to see if it is clear.
| - You prevent infection in the blocked tear duct by keeping the eye
clean. You wipe away eye drainage using a clean cotton ball or washcloth.
- You may massage the area if your doctor tells you to. This may be
done 2 or 3 times a day for several months.
- If the duct is still
blocked after your child's first birthday, you can decide to have the probing
procedure then.
| | What are the benefits? | - Probing opens the tear ducts in about 90 of 100 babies who have
blocked ducts.1 This means that it doesn't open the
ducts in 10 out of 100 babies.
- Your baby avoids the rare risk of
getting infections from blocked tear ducts.
| - Most blocked tear ducts go away on their own by a baby's first
birthday.
- Your baby avoids the risks of a probing procedure.
- You avoid the cost of a procedure your baby might not need.
| | What are the risks and side effects? | - There is a rare risk of scarring that can cause a blockage of its
own. If this happens, the duct may be hard to open if probing is repeated.
- Other risks include:
- Infection.
- Bleeding.
- Problems from
general anesthesia.
| - Very rarely, babies can get an infection from blocked tear
ducts.
- Also rarely, repeat infections from blocked tear ducts may
cause scarring, which is usually fixed by probing.
|
Personal storiesAre you interested in what others
decided to do? Many people have faced this decision. These
personal stories personal stories may help you
decide. Personal stories about having a probing procedure to open a baby's blocked tear ductThese stories are based on information
gathered from health professionals and consumers. They may be helpful as you
make important health decisions. "Sevi was
born with blocked tear ducts, and both eyes were mucky from the beginning. It
really stressed me out worrying that his eyes were infected. I used antibiotic
drops on and off when his eyes were red. But I worried about using the drops
too much. Every morning his eyes were glued shut with gunk. It bothered me that
people were always commenting about his eyes. When the ophthalmologist said he
could have a probing at 6 months, I was ready." "I have a
12-month-old son, Ismail, whose tear ducts just finally opened up. I was very
resistant to probing. I just could not be adequately convinced that the
procedure was necessary. I know that the possible serious side effects of
anesthesia are very rare, but I couldn't justify that risk for a condition that
caused me some inconvenience but did not jeopardize my son's
well-being." "When my eldest daughter, Whitney, was 1
year old, we decided it was time to have the procedure to open her tear duct.
We had waited patiently for it to open on its own, but it had not. She would
not let me clean them, and it was becoming very difficult to keep her eyes
clean. She began to rub them a lot and they were red most of the time. We had
the procedure, and her eye is fine now." "My daughter
Tamera was born with a blocked tear duct. It really bothered me because she
always had a teary eye. When she had a cold, she used to have mucus in her eye
and her eye was matted in the morning. In some of her baby pictures, she has
tears in her eye. I hated that my perfect little baby didn't look perfect, but
I just could not stand the thought of putting something sharp near her eye,
especially while she was awake. Eventually, when Tamera was 8 months old, the
tear duct opened." 3. Your FeelingsYour personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to choose probing to open a blocked tear duct
Reasons to wait and see if the blocked tear duct opens on its own
I have a hard time keeping my baby's eye clean.
I don't have a hard time keeping my baby's eye clean.
More important
Equally important
More important
I'm worried about scarring from repeat infections.
I'm not worried about scarring.
More important
Equally important
More important
I want to take care of this problem now.
I don't want my baby to have a medical procedure for a problem that might get better on its own.
More important
Equally important
More important
I'm not worried about the risks of probing.
I'm worried about the risks of probing.
More important
Equally important
More important
I don't like the way blocked tear ducts make my baby look.
I don't mind the way blocked ducts make my baby look.
More important
Equally important
More important
My other important reasons:
My other important reasons:
More important
Equally important
More important
4. Your DecisionNow that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Leaning toward
Undecided
Leaning toward
5. Quiz Yourself
Check the facts.
1.
Will most blocked tear ducts open on their own?
You are right. Most blocked tear ducts open on their own by the time a baby is 1 year old.
2.
Is probing a good choice if your baby is 1 year old and the tear duct is still blocked?
You're right. Probing may be advised if your baby is 1 year old and the tear duct is still blocked.
3.
Can blocked tear ducts hurt your baby's vision?
You are right. A blocked tear duct doesn't hurt your baby's vision.
Decide what's next.
1.
Do you understand the options available to you?
2.
Are you clear about which benefits and side effects matter most to you?
3.
Do you have enough support and advice from others to make a choice?
Certainty.
1.
How sure do you feel right now about your decision?
Not sure at all
Somewhat sure
Very sure
2.
Check what you need to do before you make this decision.
- Nothing. I'm ready to take action.
- I want to discuss the options with others.
- I want to learn more about my options.
3.
Use the following space to list questions, concerns, and next steps.
References Citations Olitsky SE, et al. (2007). Disorders of the lacrimal
system. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 18th ed., chap. 624, p. 2587. Philadelphia: Saunders
Elsevier. Mannor GE, et al. (1999). Factors affecting the
success of nasolacrimal duct probing for congenital nasolacrimal duct
obstruction. American Journal of Ophthalmology, 127(5):
616–617.
| |