Right eye shows discharge from NLD obstruction
Tearing and discharge in infancy is often caused by a blocked tear duct. See photo showing discharge right eye . Normally tears drain into the back of the nose byway of a small tube called the nasal lacrimal duct (NLD). If you cry you get a runny nose as tears drain to the back of your nose. NLD obstruction because the duct is not fully open stops the tears from draining normally into the nose so tears build up and can get infected. In many cases the duct will open spontaneously. Because of this most pediatricians suggest waiting until 6 to 12 months of age before considering the surgical procedure of NLD probing. During the waiting period some advocate massage, and sometimes antibiotic drops are indicated. If the tearing does not resolve by 6 months to 12 months the nasolacrimal duct probing is the primary procedure of choice. It is a simple but delicate procedure that usually takes less than 5 to 10 minutes to perform. A small wire probe (Bowman probe) is passed through the punctum into the nasolacrimal system to breakthrough a tissue membrane at the distal end of the nasolacrimal duct at Hasner’s valve. (see video). Probing is successful in approximately 90 % of cases. If probing is not successful then silicon tube placement is usually indicated.
