The Watering Eye: Myths and Challenges!!

Hi people! I am Dr Nandini Bothra, an eye specialist at the L V Prasad Eye Hospital, Hyderabad. I specialize in eye plastic surgery and problems with watering eyes.

If you have a child with watering from the eyes with or without discharge – then this post is for you.

A watering eye in a child can be due to multiple reasons, such as allergy, cold and cough. If it is occasional and not present since birth or a few weeks after birth, it is usually self-limiting. In some children however, the tear duct can be blocked since birth. In simple terms, this can be compared to the blockage in the drainage pipe in your kitchen sink, leading to water pooling and collection of dirt.

So what happens when your child’s eye waters? There can be multitude of possibilities ranging from obstruction in drainage due to blockage in the tear duct by birth or an acquired condition as simple as the child having cold and cough.

Here is a list of things to consider when you see that your child’s eye is watering:

Blocked tear duct can be treated by eye doctors, but there is something that you can do at home too! All you need is an understanding of the problem, and guidance from an eye plastic surgeon.

• If the child is less than a year old – lacrimal sac compressions or ‘massage’ as is called in normal terms can be attempted. The important thing to stress upon is the use of ‘CORRECT TECHNIQUE’ for lacrimal sac massage (see video). If done correctly, 96% of kids can be cured with massage itself.

MYTH!!!

Please give my child ‘SOME DROPS’ till we do massage and wait for the condition to resolve – Here what we need to understand is that the eye is watering because the duct is blocked. So if water is overflowing out of the eye, how is the drop we instill going to help. Any drop we instill during this time for this condition is going to overflow and flow out. So ‘NO DROPS,ONLY MASSAGE’ is the mantra here. Drops is not the solution to the problem. It is used rarely in case of severe infection only.

• If the child is more than a year old – the treatment would be syringing + probing . Now, you need to understand this is not surgery, we do not ‘CUT’ anything. It’s a small procedure. However, since we are dealing with kids, they would not allow any procedure without the use of general anesthesia.

CHALLENGE!!!

General anesthesia in a kid so small! Is it safe? – Well, no procedure comes without complications and general anesthesia has its own set of complications. But in well trained hands and with all the required investigations and precautions in place, the chances of having complications is very minimal. In a healthy child, the risk is as low as any other human being.

MYTH!!!

Then why not wait till the child is a little older and then do the procedure – Imagine a balloon now. It is nice and elastic initially. Once we blow into it and then deflate it later, it loses its tonicity and elasticity and becomes unshapely. Similarly, the lacrimal sac (the bag where water collects before it goes into the nose) loses its tone if it remains dilated (or full) for a very long time. Thus, if we delay the procedure for too long, the chances of failure increases, which means we will have to subject the kid to a major surgery once the bony growth is complete.

It is always good to consult an ophthalmologist for any queries or concerns. Also, you can freely write to me for any further clarifications if needed.

I hope this was helpful. I will come up with more questions frequently encountered in the clinic with logical and scientific explanation for the same.

Nandini Bothra
Consultant, Ophthalmic Plastic Surgery Services,
L V Prasad Eye Institute, Hyderabad.
Email id: nan_bothra@yahoo.com