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Blocked Tear Ducts: Should My Baby Have a Probing Procedure

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Blocked Tear Ducts: Should My Baby Have a Probing Procedure?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

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Blocked Tear Ducts: Should My Baby Have a Probing Procedure?

1

Get the
facts

2

Compare
Options

3

Your
Feelings

4

Your
Decision

5

Quiz
Yourself

6

Your Summary

Get the facts

Your 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.
- Your newborn has signs of tear duct infection.
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.

FAQs

What should you know about probing?

The probing procedure to open a blocked tear duct is usually done in a baby who is at least 6 months of age. If a baby has a problem from the blockage, such as infection, probing may be done before 6 months of age. Probing involves passing a probe through the blocked tear duct to open it. Probing 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 clinic or hospital. Your baby may need to have general anesthesia. Most babies go home the same day.

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 may be used for 4 to 6 more weeks. If your baby still has too much tearing, the probing procedure may be 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?

Before age 3, 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.

Most of the time, probing works well to clear simple blockages. When blockages are more complicated, probing works about half the time. After age 5 or 6 years, probing does not work well in children.²

Probing may be done again if it doesn't work the first time. Most children under the age of 4 who have a simple tear duct blockage can be helped by one probing.

What are the risks of probing?

A probing procedure has the same risks as surgery, such as infection, bleeding, and risks of anesthesia.

Children may need general anesthesia to keep them totally still during the procedure. It has greater risks than local anesthesia.
Local anesthesia has few or no risks, but the pain control may not be as good. Also, babies may need to be restrained to keep them very still during the procedure.

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.

In very rare cases, 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.
In rare cases, 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 is very unlikely to 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.
Your newborn has a tear duct infection.

Compare your options

Compare


What is usually involved?
What are the benefits?
What are the risks and side effects?

Schedule probing for your baby Schedule probing for your baby

Probing is done in a clinic or hospital. Your baby may need to have general anesthesia. Most babies go home the same day.
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.

Probing opens the tear ducts in about 80 out of 100 babies who have blocked ducts.³ This means that it doesn't open the ducts in 20 out of 100 babies.
Your baby avoids the rare risk of getting infections from blocked tear ducts.

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.

Wait to see if the duct opens on its own Wait to see if the duct opens on its own

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.

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.

In very rare cases, babies can get an infection from blocked tear ducts.
In rare cases, repeat infections from blocked tear ducts may cause scarring, which is usually fixed by probing.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Personal stories about having a probing procedure to open a baby's blocked tear duct

These 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. The doctor sometimes prescribed antibiotic drops when Sevi's 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.

Marta, age 35

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 needed. 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.

Stanley, age 22

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 her eye, and it was becoming very hard to keep it clean. She began to rub her eye a lot, and it was red most of the time. We had the procedure, and her eye is fine now.

Beverly, age 26

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.

Myna, age 40

What matters most to you?

Your 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

Where are you leaning now?

Now 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.

Probing

Waiting

Leaning toward

Undecided

Leaning toward

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts

Key concepts that you understood

Key concepts that may need review

Getting ready to act

Patient choices

What matters to you

Credits and References

Credits

Credits	Healthwise Staff
Primary Medical Reviewer	Adam Husney, MD - Family Medicine
Specialist Medical Reviewer	Christopher J. Rudnisky, MD, MPH, FRCSC - Ophthalmology

References

Citations

Wright KW (2008). Tearing. In Pediatric Ophthalmology for Primary Care, 3rd ed., pp. 145–157. Elk Grove Village, IL: American Academy of Pediatrics.
Hurwitz JJ (2009). The lacrimal drainage system. In M Yanoff, JS Duker, eds., Ophthalmology, 3rd ed., pp. 1482–1487. Edinburgh: Mosby Elsevier.
Olitsky SE, et al. (2011). Disorders of the lacrimal system. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 2165–2166. Philadelphia: Saunders.

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Blocked Tear Ducts: Should My Baby Have a Probing Procedure?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

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 facts

Your 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.
- Your newborn has signs of tear duct infection.
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.

FAQs

What should you know about probing?

The probing procedure to open a blocked tear duct is usually done in a baby who is at least 6 months of age. If a baby has a problem from the blockage, such as infection, probing may be done before 6 months of age. Probing involves passing a probe through the blocked tear duct to open it. Probing 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 clinic or hospital. Your baby may need to have general anesthesia. Most babies go home the same day.

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 may be used for 4 to 6 more weeks. If your baby still has too much tearing, the probing procedure may be 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?

Before age 3, 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.

Most of the time, probing works well to clear simple blockages. When blockages are more complicated, probing works about half the time. After age 5 or 6 years, probing does not work well in children.²

Probing may be done again if it doesn't work the first time. Most children under the age of 4 who have a simple tear duct blockage can be helped by one probing.

What are the risks of probing?

A probing procedure has the same risks as surgery, such as infection, bleeding, and risks of anesthesia.

Children may need general anesthesia to keep them totally still during the procedure. It has greater risks than local anesthesia.
Local anesthesia has few or no risks, but the pain control may not be as good. Also, babies may need to be restrained to keep them very still during the procedure.

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.

In very rare cases, 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.
In rare cases, 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 is very unlikely to 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.
Your newborn has a tear duct infection.

2. Compare your 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 clinic or hospital. Your baby may need to have general anesthesia. Most babies go home the same day. 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 80 out of 100 babies who have blocked ducts.³ This means that it doesn't open the ducts in 20 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.	In very rare cases, babies can get an infection from blocked tear ducts. In rare cases, repeat infections from blocked tear ducts may cause scarring, which is usually fixed by probing.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Personal stories about having a probing procedure to open a baby's blocked tear duct

These 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. The doctor sometimes prescribed antibiotic drops when Sevi's 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."

— Marta, age 35

"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 needed. 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."

— Stanley, age 22

"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 her eye, and it was becoming very hard to keep it clean. She began to rub her eye a lot, and it was red most of the time. We had the procedure, and her eye is fine now."

— Beverly, age 26

"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."

— Myna, age 40

3. What matters most to you?

Your 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. Where are you leaning now?

Now 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.

Probing

Waiting

Leaning toward

Undecided

Leaning toward

Credits

By	Healthwise Staff
Primary Medical Reviewer	Adam Husney, MD - Family Medicine
Specialist Medical Reviewer	Christopher J. Rudnisky, MD, MPH, FRCSC - Ophthalmology

References

Citations

Wright KW (2008). Tearing. In Pediatric Ophthalmology for Primary Care, 3rd ed., pp. 145–157. Elk Grove Village, IL: American Academy of Pediatrics.
Hurwitz JJ (2009). The lacrimal drainage system. In M Yanoff, JS Duker, eds., Ophthalmology, 3rd ed., pp. 1482–1487. Edinburgh: Mosby Elsevier.
Olitsky SE, et al. (2011). Disorders of the lacrimal system. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 2165–2166. Philadelphia: Saunders.

Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.

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Last Revised: November 8, 2011

Author: Healthwise Staff

Medical Review: Adam Husney, MD - Family Medicine & Christopher J. Rudnisky, MD, MPH, FRCSC - Ophthalmology

eMedicineHealth Medical Reference from Healthwise

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