Tear duct obstruction in an infant is best managed with which technique?

Tear duct obstruction in an infant is best managed with which technique?

• A. Advise eyelid scrubs.
• B. Teach tear duct massage.
• C. Perform surgery to create a tear duct.
• D. Prescribe topical antibiotic drops.

Answer: (B)

Tearing in infants is most often due to a congenital blockage at the distal end of the tear drainage system (the valve of Hasner). The best initial management is teaching tear duct massage to the parents. Gently massaging the lacrimal sac area several times daily helps express fluid and pressure through the valve, encouraging it to open and improving drainage. This noninvasive approach is safe, easy for caregivers to do, and many infants improve or completely resolve within months. Gentle warm compresses and good eye hygiene can be used as adjuncts, and antibiotics are only needed if there is a clear infection with purulent discharge. If tearing or infection persists beyond about a year or is frequent/severe, referral for procedures to open the duct, such as probing, may be considered.

Tearing in infants is most often due to a congenital blockage at the distal end of the tear drainage system (the valve of Hasner). The best initial management is teaching tear duct massage to the parents. Gently massaging the lacrimal sac area several times daily helps express fluid and pressure through the valve, encouraging it to open and improving drainage. This noninvasive approach is safe, easy for caregivers to do, and many infants improve or completely resolve within months. Gentle warm compresses and good eye hygiene can be used as adjuncts, and antibiotics are only needed if there is a clear infection with purulent discharge. If tearing or infection persists beyond about a year or is frequent/severe, referral for procedures to open the duct, such as probing, may be considered.