For the last 5 or 6 months or so, or it may even be longer, one loses track of time, A2 has had a gunky eye. We’ve had him at the GP and Pediatrician numerous times, sometimes for the eye only, sometimes the eye and something else.
He wakes up with a gunky eye, and by gunky I mean green, slime-like stuff on the lower lid, in his eye lashes and around his eye. Always just the left eye. Sometimes there’s so much stuff, he can’t even open it, because the lashes are stuck together. He wasn’t born with this problem, I mean surely I would’ve noticed that. I think it started shortly after he got so sick and ended up in hospital. He’s never really been 100% healthy since then. Always a cold or a cough or some snot lingering. And then the eye started.
Signs of Blocked Tear Ducts
Kids with blocked tear ducts usually develop symptoms between birth and 12 weeks of age, although the problem might not be apparent until an eye becomes infected. The most common signs are excessive tearing, even when a child is not crying (this is called epiphora). You also may notice pus in the corner of the eye, or that your child wakes up with a crust over the eyelid or in the eyelashes.
At first we thought it was an infection. Took him to the the GP, got some ointment to put in and it worked. For a few days. And then it started again. We put ointment again. Clears up. Starts again 2 or 3 days later. Sometimes this coincided with him being on oral antibiotics, so it would be clear for a few days longer. But Rinse. Repeat.
Then I did some research on google with regards to gunky eyes in babies. Besides an obvious infection, the most common answer I found was that sometimes a baby’s tear duct doesn’t completely open when they are little little people. This leads to their tear duct being blocked and then they get the gunky eye. Usually this should rectify itself within a year or two. To help speed this along, you can massage their little tear ducts to assist the drainage manually.
Many children are born with an underdeveloped tear-duct system, a problem that can lead to tear-duct blockage, excess tearing, and infection.
Blocked tear ducts are common in infants; as many as one third may be born with this condition. Fortunately, more than 90% of all cases resolve by the time kids are 1 year old with little or no treatment.
So we tried to do that. The above information was passed along to all of the caregivers involved. It didn’t make much of a difference, but I think we were doing it wrong. Most of the documentation tells you to do it, but not HOW to do it. Then concerns were raised about lasting damage to the eye, and we should get him to the specialist (at this time of the year, when his medical aid has already been depleted). Eventually I made an appointment with an Ophthalmologist (Eye Specialist). All the documentation also tells you to take your baby to your doctor if you are concerned, but our doctors weren’t fixing the problem. I was hoping the ophthalmologist would be able to fix him.
Our appointment was yesterday, and I explained everything to him. He confirmed that indeed, it was not an infection (no red eye, confined to one eye only), and yes, the most likely cause would be a blocked tear duct.
Causes of Blocked Tear Ducts
Many kids are born without a fully developed nasolacrimal duct. This is called congenital nasolacrimal duct obstruction or dacryostenosis. Most commonly, an infant is born with a duct that is too narrow or has a web of tissue blocking the duct and therefore doesn’t drain properly or becomes blocked easily. Most kids outgrow this by the first birthday.
Other causes of blockage, especially in older kids, are rare. Some kids have nasal polyps, which are cysts or growths of extra tissue in the nose at the end of the tear duct. A blockage also can be caused by a cyst or tumor in the nose, but again, this is unusual in children.
Trauma to the eye area or an eye injury that lacerates (cuts through) the tear ducts also could block a duct, but reconstructive surgery at the time of the accident or injury may prevent this.
He showed me a picture similar to this one above. Apparently, the pipe that drains the tears away in the nose is blocked. This could be due to either a polyp in the nose, or inflammation of the ducts. That’s the most probable cause, because A2 is just about permanently sick. He then explained that because the tears don’t drain, they come out the top, the eye, and that’s why his eye is watery all the time. The green stuff is mucus build up in the pipe. SO basically my kids’ snot comes out his eye, rather than his nose O_o
He showed me exactly how to massage the tear duct, so we can manually drain the tear duct and hopefully flush out everything that’s building up, into the nose. Basically, you have to use a small finger, or an ear bud, and completely cover the entire inside corner of the eye (called the puncta in the above picture). Then you kind of have to press down on it, behind the bone. You’ll feel what I mean if you try this on yourself. But don’t press too hard and stick your eye out with your finger! Use clean hands – VERY IMPORTANT to reduce the risk of infection!!
Treating Blocked Tear Ducts
Kids with blocked tear ducts often can be treated at home. Your doctor or pediatric ophthalmologist may recommend that you massage the eye several times daily for a couple of months. Before massaging the tear duct, wash your hands. Place your index finger on the side of your child’s nose and firmly massage down toward the corner of the nose. You may also want to apply warm compresses to the eye to help promote drainage and ease discomfort.
If your child develops an infection as a result of the tear-duct blockage, the doctor will prescribe antibiotic eye drops or ointment to treat the infection. It’s important to remember that antibiotics will not get rid of the obstruction. Once the infection has cleared, you can continue massaging the tear duct as the doctor recommends.
He also said we can stop the use of the ointment for now. It’s not doing anything now anyway. Unless A2 develops an infection. In our case, signs of an infection would be red eyes added to the gunky mix, because he already has the gunky eyes (so that’s not a reliable indicator).
I asked what kind of time-frame should we be looking at, this whole massaging thing (step 1). Apparently we need to give it a year or so. If there is still no drastic improvement, our next step will be to have the tear duct flushed with a syringe, while A2 is under general anesthesia (this is just to prevent him from squirming and causing avoidable damage). This will be step 2. Hopefully we never have a step 3, but if we do, I’ll investigate it more thoroughly before anything happens.
He asked if I’ve taken him to an ENT. Well, no, not in the last while. When he was sick in the hospital earlier, he was examined extensively. Twice, by two different doctors. The first one did his grommets. Neither of these doctors noticed anything out of the ordinary. Well, not that they mentioned anyway. If A2′s situation/symptoms get any worse, then I’ll re-evaluate the need to take him to the ENT. Perhaps in the new year, when the Medical Aid funds have been restored.
I did ask him very specifically about long term effects (like a year or so) of this gunky eye blocked tear duct thing. He reassured me that unless there is an infection involved, we have nothing to worry about. It’s common, it’s normal, it’s treatable. With time, we’ll fix this thing!
It was nice having the doctor confirm everything I already felt with my motherly instincts. They are on track, even if I’m the only one who believes in them.
**All the quoted bits above, were taken from here: http://www.childrenscolorado.org/wellness/info/parents/21306.aspx **