Sticky Eyes & Blocked Tear Ducts
Why so many babies have a sticky or watery eye in the first months, the simple cleaning and massage routine that helps, and the signs of something more serious.
- Last reviewed
- Sources cited
- 4 sources
- Author
- Dr Jubal John, FRACP
- Category
- medical guides
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Take-home
Around 6–20% of newborns have symptoms of nasolacrimal duct obstruction (StatPearls), commonly a blocked tear duct (dacryostenosis) where a thin membrane at the bottom of the duct hasn’t fully opened. The eye stays white, the baby is well, there’s just morning crust and tears that overflow. Most cases (~78% by 12 months) resolve spontaneously with cleaning and gentle massage. A red, swollen, or painful eye in an unwell baby is different, that needs same-day review.
Blocked tear duct vs. conjunctivitis: at a glance
Green — usually fine
Blocked tear duct (the common one)
- Yellow / whitish crust in the inner corner, especially after sleep
- Watery eye, tears overflow when not crying
- White of the eye stays white, baby is well, no fever
- Often one side worse than the other
- Starts in the first 2–6 weeks
Amber — be alert
Conjunctivitis
- Red whites of the eye (the “pink eye” look)
- Pus or yellow-green discharge that keeps coming back through the day
- Eyelids puffy or swollen, baby rubs the eye
- Often follows a cold (viral) or affects both eyes
- Worth a same-day GP review. See the HealthDirect guide for treatment.
Red — act now
Needs urgent review (seek same-day medical attention or attend ED)
- A baby under 1 month with red, swollen or pus-filled eye
- Severe eyelid swelling that closes the eye
- Redness spreading from the eye onto the cheek or forehead
- An unwell baby (fever, lethargy, poor feeding) with eye changes
- Eye injury, chemical splash, or light hurting the eyes
Why blocked ducts happen
The tear duct runs from the inner corner of the eye down to the inside of the nose, that’s why your nose runs when you cry. In some babies the valve at the bottom of the duct hasn’t fully opened at birth. Tears can’t drain, so they pool, crust, and overflow. It’s structural, not infectious: the eye itself is healthy.
What helps at home
The two-step routine
- Clean the eye with cooled boiled water on a clean cotton ball, wipe from the inner corner outward, one wipe per ball, fresh ball each time. Once or twice a day, more if there’s a lot of crusting.
- Gentle lacrimal sac massage: see below. 5–10 strokes, 2–3 times a day; easy to add to nappy changes.
That’s the whole routine. No drops, no antibiotics are needed for an uncomplicated blocked duct.
The massage (Crigler manoeuvre)
With clean, short fingernails, place your fingertip on the bony ridge at the inner corner of the eye (between the eye and the side of the nose) and press gently inward and downward with small, slow strokes, the firmness you’d use to test a ripe avocado. Ask your GP, MCH nurse, or paediatrician to demo at the next visit; it’s easier to copy after seeing it once.
What not to do
- No breast milk, chamomile, eyebright, or salt water in the eye: no evidence any of these help, real infection risk
- No chloramphenicol or other antibiotic drops without a doctor’s assessment, they don’t fix a structural blockage and can mask infection
- Don’t share face cloths between siblings, especially if one has crusting
Neonatal conjunctivitis: the one to know about
A red or pus-filled eye in a baby under 1 month is always worth a same-day review. In rare cases it can be caused by serious infections acquired around birth (chlamydia, gonorrhoea, herpes simplex) that need specific treatment and can affect vision if missed. Hospital midwives and paediatricians screen for this routinely.
When the duct is still blocked at 12 months
If a sticky eye hasn’t cleared by 12 months with home care, an ophthalmology review is reasonable. The usual treatment is a brief outpatient probing procedure (office probing succeeds in around 75% of eyes in children aged 6 to under 15 months; success rates fall with older age). Lifelong blocked ducts are very uncommon.
Related reading
- Common newborn findings, “is this normal?” companion
- When to seek help
Not sure if it's a blocked duct or an infection?
Your GP or MCH nurse can usually settle it with a brief look and demonstrate the massage technique, or refer if it's something more.