Watery eyes, medically known as epiphora, are frequent in newborns and young infants. This symptom describes the excessive overflow of tears onto the cheek, sometimes accompanied by discharge. While concerning for parents, epiphora in this age group is usually a minor issue related to developmental timing. Most cases resolve on their own, but understanding the causes is important for safe home management and knowing when to seek professional advice.
The Primary Culprit Blocked Tear Ducts
The most common reason for persistent eye watering in infants is congenital nasolacrimal duct obstruction (CNLDO), or a blocked tear duct. This condition affects approximately 5% to 20% of newborns and occurs when the nasolacrimal duct is not fully open at birth. Tears are produced in the lacrimal glands and usually drain through tiny openings in the corner of the eye, moving down a tube into the nose.
When the tear duct is blocked, often by a thin membrane, tears accumulate on the eye’s surface and spill over the eyelid. This overflow results in constant watering, which may be mild or noticeable only when the baby cries or is exposed to wind. Symptoms usually include clear tears pooling in the corner of the eye and mild stickiness or crusting, especially upon waking.
The condition generally resolves spontaneously as the baby grows and the membrane opens, with about 95% of cases clearing by the first birthday. To assist this process, pediatricians often recommend Crigler massage. This technique is designed to increase pressure within the lacrimal sac to help open the obstruction.
To perform the Crigler massage, ensure your hands are clean. Place the tip of your index finger on the side of the baby’s nose, next to the inner corner of the affected eye. Apply firm but gentle pressure and stroke your finger downward along the side of the nose toward the cheekbone. Repeat this downward motion three to five times per session, ideally performing sessions multiple times a day.
Infection and Environmental Causes
Watering may also be triggered by factors other than a mechanical blockage, such as infection or irritation. Conjunctivitis, or pink eye, causes inflammation of the eye lining and can be either bacterial or viral. Differentiating between the two types often depends on the nature of the discharge.
Bacterial conjunctivitis typically produces a thick, colored discharge (often yellow or green) that can cause the eyelids to stick together, particularly after sleep. Conversely, viral conjunctivitis, which often accompanies a common cold, tends to produce a thin, watery discharge.
Watery eyes can also be a protective reaction to environmental irritants. Exposure to dust, smoke, pet dander, or strong winds causes the eye to overproduce tears to wash the irritant away. Although less common in very young infants, allergic reactions to pollen or other allergens may cause redness, watering, and itching. A foreign object, like a stray eyelash or debris, can also cause acute tearing in one eye until it is flushed out.
At-Home Cleaning and Comfort Measures
Regardless of the underlying cause, maintaining good hygiene around the eye is important. The primary goal of home care is to safely remove accumulated tears or discharge to prevent secondary skin irritation or infection. This cleaning should be done gently, as the skin around the eye is sensitive.
Begin by washing your hands thoroughly. Use a soft, clean cotton ball or cloth moistened with lukewarm water or sterile saline solution. Wipe the eye area gently, always moving from the inner corner of the eye (near the nose) outward toward the ear.
Use a fresh section of the cloth or a new cotton ball for each swipe, and use separate materials for each eye to avoid transferring potential infection. If tears are constantly spilling onto the cheek, applying a thin layer of petroleum jelly to the skin below the eye can help prevent irritation and chafing.
Warning Signs and Professional Treatment
While many cases of infant epiphora resolve spontaneously or with simple home care, certain symptoms require prompt evaluation. Immediate medical attention is needed if the baby develops a fever or exhibits extreme sensitivity to light (photophobia). Swelling, severe redness, or a painful lump near the tear duct area are signs of a spreading infection, such as dacryocystitis.
The presence of copious, thick yellow or green discharge, or if the baby’s cornea appears cloudy, warrants a medical visit. If watery eye symptoms persist beyond 9 to 12 months, the pediatrician may refer the infant to an ophthalmologist. If the blocked tear duct does not clear on its own, a minor procedure called nasolacrimal duct probing may be recommended.
This procedure involves the specialist passing a thin instrument through the tear duct to open the membrane obstruction. Probing is a quick outpatient procedure, often performed under brief general anesthetic, and has a high success rate in resolving the blockage. For infections, the doctor may prescribe antibiotic eye drops or ointment, depending on the determined cause.