Common causes of tearing in children – impingement

  The direction of normal eyelashes is to grow outward towards the eye without touching the surface of the eye; in the case of impaired eyelashes, the eyelashes are turned backwards towards the eye and touch the cornea and conjunctiva (as shown below), which can cause damage to the epithelium of the conjunctiva and cornea, resulting in photophobia, tearing, discharge (also known as “eye discharge” and “eye mucus”), etc. (also known as “eye discharge” and “eye mucus”).  Inverted eyelashes are a common cause of lacrimation in infants and children. Various causes of entropion (such as trachoma, entropion, congenital malformations, etc.) can cause it. In infants and toddlers, impingement is often caused by congenital entropion, mostly in the lower lid. Most congenital entropion is caused by an inner canthus, overdevelopment of the orbicularis muscle at the lid margin, or underdevelopment of the lid plate (below).  Because congenital entropion tends to heal on its own as the child ages, and because the eyelashes of infants and toddlers are soft and soft, the damage to the eye surface is relatively minor, so there is no urgency to treat it surgically. You can usually pull down on the eyelid with your fingers to reduce irritation. However, if the child has significant symptoms of irritation such as photophobia and tearing, and if the eye discharge is high, surgical treatment may be considered. A common surgical procedure is lower lid sutures (this procedure has no surgical incisions).