Pediatric ophthalmology clinics often have babies come to see tearfulness, and many young mothers and fathers have learned something about it online, thinking that tearfulness is tear duct failure and dacryocystitis. In fact, many causes can cause tears in babies, and not all need to be treated with antibiotic eye drops. Here we will talk specifically about several common eye diseases that cause tearing in babies. One, congenital lacrimal obstruction (neonatal dacryocystitis): this cause of tears is usually started soon after birth, can be single or double eyes, it is due to the end of the tear duct of the baby after birth, the membrane tissue is not broken, or tear system there is a congenital developmental malformation, resulting in the normal secretion of tears to the nasal cavity discharge is blocked, there are tears, so the tears do not stop when, and often accompanied by secretions This is also commonly known as eye drops. If your baby is less than three months old, you can take conservative treatment: massage the tear sac area; use antibiotic eye drops when there is a combination of bacterial infections, but you can stop using them when the drops disappear, and there is no need to use antibiotic eye drops for a long time to avoid bacterial resistance and damage to your baby’s cornea. For babies older than three months, early tear duct irrigation and tear duct exploration can be considered. Studies have shown that lacrimal duct irrigation is more effective in children within one year of age than in children after one year of age, which is related to inflammatory adhesions caused by long-term inflammation in the lacrimal duct and dilatation of the lacrimal sac that reduces the effectiveness of the procedure; if lacrimal duct irrigation treatment is not effective, lacrimal duct intubation surgery needs to be considered. Second, allergic conjunctivitis: the baby mainly manifests intermittent tears, mainly to the wind, tears indoors is not obvious, usually not accompanied by secretions, some babies have blinking, eye rubbing and other symptoms, the baby often has a history of allergic rhinitis, asthma, eczema, ringworm, etc., need to point with emmetine fumarate, sodium cromoglycate, diclofenac sodium, artificial tears and hormones such as anti-allergy drugs. Generally, antibiotic eye drops are not routinely used unless there is an indication for a combination of bacterial infections with excessive eye discharge. Congenital lower lid entropion (inverted eyelashes): Some babies are born without tears and gradually start to get teary-eyed after one or two years of age, and the eyelashes of the lower eyelids are always wet against the eyeballs. This is due to the low nasal bridge, inner canthus, vertical growth of the eyelashes on the inside of the lower eyelid, and reflexive tearing due to the inverted eyelashes stimulating the black eyeball (cornea), which can seriously damage the cornea and complicate keratitis. Parents can help their child to pull on the lower eyelid frequently or fix it with tape under the guidance of a doctor. When the symptoms of photophobia and tearing are not severe, artificial tears can be used frequently to protect the corneal epithelium, while antibiotic eye drops can be used to control the infection in case of redness and increased discharge. Thankfully, most of these babies will gradually improve as their nasal bridge and eyes develop and their lower eyelids are gradually turned out. Congenital glaucoma: The baby’s main manifestation is a large, cloudy black eye, fear of light and tears, increased intraocular pressure, and eventual optic nerve atrophy and blindness without timely treatment. Congenital glaucoma is mainly treated by surgery, apparently this kind of tearing, point with antibiotic eye drops is not effective.