Some children have a tendency to heal on their own, and in some cases the symptoms will disappear spontaneously and the tear ducts will open up naturally. In some children, tearing occurs early after birth but disappears after the first month of life because the vacuolation of the tear ducts is not completed until some time after birth. Therefore, conservative treatment is preferred for children who are seen early. A little anti-inflammatory eye medication can be used to reduce local inflammation and control the infection. Parents can give their children massage in the tear sac area at home, by squeezing the tear sac, squeeze the mucus and pus in the tear sac, which helps to reduce inflammation, and at the same time, through the force of hydrostatic pressure, it is possible to squeeze the tear duct smoothly. And regular review at the hospital for tear duct flushing to clean the tear sac and help unblock the tear ducts. Generally conservative treatment can continue until the child is 4 or 5 months old, and if the tear ducts are still not patent, surgery can be considered. The preferred surgical treatment is lacrimal duct exploration. This is done by using a probe, entering from the tear duct and following the natural shape of the tear duct all the way down to the lower opening of the tear duct – the lower end of the nasolacrimal duct – to open the blocked section in the middle. This procedure is simple, time-consuming, and minimally invasive, and can be done with local anesthesia. Most children can be cured by this method. The disadvantage is that it is suitable for cases with minor obstruction or lacrimal duct developmental abnormalities. In cases where the obstructed segment of the lacrimal duct is long, where there is significant intraoperative bleeding, where there is a risk of postoperative formation of adhesions, or in cases with severe lacrimal developmental abnormalities, such as those with bony lacrimal developmental abnormalities, the treatment is not effective, or even the surgical treatment is unsuccessful and there is little chance of lacrimal patency. If the child has had a lacrimal duct exploration and the lacrimal duct is still not patent, or even if more than one lacrimal duct exploration has been done, all unsuccessful, you can no longer operate blindly, but you need to first understand the development of the lacrimal duct and the severity of the obstruction. It is usually necessary to do a lacrimal ductography and CT examination. Before the examination, a contrast agent needs to be injected into the lacrimal duct to understand the approximate location of the obstruction and, more importantly, the development of the bony lacrimal duct. The lacrimal duct enters the nasal cavity from the lacrimal sac, and there is a naturally formed bony duct, the nasolacrimal duct, in the nasal bone for the lacrimal duct to pass through. If the bony lacrimal duct is developing normally, lacrimal intubation may be considered. There are several specific methods of lacrimal duct intubation and the silicone tubes used can vary slightly, but the general idea of the procedure is the same. It is a thin silicone tube that is implanted into the tear duct based on lacrimal duct exploration. The silicone tube commonly used in our hospital is left in the lacrimal duct in a circular shape, visible above between the upper and lower tear dots in the inner canthus, and fixed below in the nasal cavity by sutures in the nasal area. The silicone tube plays a supportive role in the tear duct, avoiding adhesions during the process of inflammation relief, bleeding absorption and wound repair in the tear duct. In addition the silicone tube has a shaping effect and can make the tear duct slowly grow and open. The lacrimal ducts need to be reviewed regularly after lacrimal intubation to flush the tear ducts. The silicone tube does not remain in the tear duct permanently and should be removed when the tear duct is clear. The tube removal time is usually 2-4 months, but in some children, the tube removal time can be extended according to the condition because of severe obstruction, or if the irrigation is not clear even after the operation with the tube. Both lacrimal duct exploration and lacrimal intubation require no incision and no scarring. When the procedure is successful and the child is fully recovered, no marks are left and no aesthetics are affected. For conditions with more severe obstruction, such as: bony lacrimal developmental anomalies, lacrimal intubation can also be difficult to perform successfully, requiring an alternative surgical approach to treatment. Imagine that the main problem in this condition is that the bone holes in the nasal bones are not well developed, the tear sac and the nasal cavity are blocked by the nasal bones, and tears cannot be drained from the eye into the nasal cavity. The key to the surgery is to artificially create a bone hole and connect the tear sac with the nasal mucosa so that tears can flow from the tear sac to the nasal cavity, this surgery is called nasal lacrimal sac anastomosis. In the past, this surgery was performed through a skin incision, which left scars on the skin and affected the aesthetics. Nowadays, with the development of medicine and the improvement of surgical techniques, nasal lacrimal sac anastomosis can be done from the nose with the help of endoscope, using the nasal cavity as the entryway, which is transnasal nasal lacrimal sac anastomosis. The operation time is short and the aesthetic impact of the scar on the skin is avoided.