Etiology Neonatal lacrimal dacryocystitis is caused by secondary infection due to the failure of the embryonic remnants of the lower nasolacrimal duct to degenerate and obstruct the lower end of the nasolacrimal duct, trapping tears and bacteria in the lacrimal sac. About 2-4% of full-term infants may have such obstruction, but the majority of residual membranes shrink and degenerate on their own within 4-6 weeks after birth and return to patency. Bony nasolacrimal duct dysplasia and stenosis are less common. Symptoms of neonatal lacrimal sacculitis are often characterized by teary eyes, a lot of eye droppings, and in severe cases, yellowish pus coming out of the inner corners of the baby’s eyes. These symptoms are usually obvious from about half a month after birth. There are three main symptoms of tearing, lots of eye stool, and eyelid eczema which is the presence of infection in the tears that can irritate the eyelid skin to produce eczema. A lump in the tear sac is found 1 to 2 weeks after birth in babies with elasticity without acute inflammatory manifestations such as redness, swelling and pressure pain can occasionally cause symptoms of acute dacryocystitis. How to treat If your baby is diagnosed with neonatal dacryocystitis, parents need not worry too much because most babies are still in the developing stage of their tear ducts after birth. Children within two months can be treated conservatively by massaging the baby’s lacrimal sac area (both sides of the bridge of the nose) from above and downward to promote the flow of tears in the direction of the nasolacrimal duct, 2 to 4 times a day for 1 minute each time. At the same time, antibiotic eye drops should be used in conjunction with medical advice, and cotton swabs should be used to wipe the secretions from the corners of the baby’s eyes before dropping the drops. After a period of treatment in this way, the film will rupture on its own and the tear duct will be open. If conservative treatment does not work for a period of time, the child can go to the ophthalmology department to flush the tear ducts and break the membrane. For babies as young as 4 months old, if pressure irrigation still does not work, a lacrimal duct exploration is required to open the tear duct by puncturing the membrane with a probe. With pressure irrigation or lacrimal duct probing, 99% of children are cured. For blockage of the lacrimal duct caused by bony stenosis or nose deformity, surgery or other methods to open the lacrimal duct should be considered. Dangers Congenital lacrimal duct obstruction, if left untreated for a long time, may lead to an acute inflammation of the lacrimal sac if the baby is infected with virulent bacteria. The dilation of the tear sac for a long time will cause the tear sac wall to lose elasticity, and later, even if the tear duct is open, the symptoms of tear overflow will still exist, and may form a permanent scarring tear duct occlusion due to the persistence of tear duct inflammation. In addition, the constant drainage of tear sac pus into the conjunctival sac can lead to inflammation of the conjunctiva and cornea, causing corneal ulcers and even the development of endophthalmitis, posing a serious potential threat to the eye. Therefore, once you find that your baby’s eyes are always watery, you should promptly take your baby to a regular hospital for treatment. How to prevent and control In the group of babies born within 10 days, the incidence of neonatal dacryocystitis reaches 0.3% to 0.5%. This means that the incidence of congenital dacryocystitis is high. However, as long as parents pay attention to the baby’s eyes and find that there is overflowing tears with a lot of eye droppings, promptly go to the hospital, the treatment is still very effective.