| By three months of age many children have sticky or watery eyes
because of faulty tear drainage. The commonest cause of this problem is
delayed development of the nasolacrimal duct that connects the tear sac
with the nose. In small babies this is a very common problem, with up
to 20% having some of the symptoms. However, the great majority of
these tear ducts begin to work normally at some point during the first
year of life; in fact, only a very small number of children still have
symptoms at 12 months of age. Because most children get better by
themselves, no treatment is recommended other than cleaning away
crusting with cooled boiled water. Drops and ointments are thought to
make little difference unless a definite conjunctivitis develops, with
the white of the eye inflamed.
| Chances of an affected
child recovering without treatment by 12 months of age |
| Child's age (in
months) | Proportion that will
recover |
| 1 | 96% |
| 2 | 93% |
| 3 | 90% |
| 4 | 86% |
| 5 | 82% |
| 6 | 75% |
| 7 | 64% |
| 8 | 49% |
| 9 | 36% |
| 10 | 23% |
| 11 | 5% |
After 12 months of age, if the problem
persists the chances of it clearing up without treatment are reduced,
and many parents will consider that it is time for something to be
done, especially if the eye has been very sticky as well as watery.
Surgical treatment is the passage of a fine probe through the tear
passages to break down any obstructions; this is done as a day case and
involves a short general anaesthetic. Like all anaesthetics, this
carries a very small risk of serious complications, but the procedure
produces a rapid and complete cure in about 75% of cases. Even if it
does not produce a cure, the findings will indicate what further
treatment is required. There are no scars or stitches.
Waiting longer is an alternative, especially if
the symptoms do not seem so severe, as some one year old children can
still get better without treatment. About 60% of all those who still
have the problem on their first birthday are free of symptoms by the
time they are 2 years old, and most of these settle by the time they
are 18 months. The advantage of this option is that it may avoid an
operation, but there is also a disadvantage. Of those children who are
still not better at age 2, about half will respond at once to a
probing, and have therefore simply had their treatment delayed.
However, there is no good evidence to suggest that delaying treatment
reduces the chances of success if a probing is in the end needed, and
some children even get better after their second birthday without
treatment.
Your doctor will discuss these choices, and any
special issues in relation to your own child, to help you decide on the
treatment you want. |
