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Childhood Tearing

Epiphora is the Correct Term

The nasolacrimal excretory apparatus develops as a solid cord of cells that canalizes relatively late in gestational life.

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This hollowing process begins at the middle and proceeds to both ends, explaining why nasolacrimal duct obstruction is due most commonly to patency at the bottom of the nasolacrimal duct as it enters the nose or at the top where the puncta may be found to be impatent.

Because most congenital nasolacrimal duct obstructions clear without intervention (2–4), treatment is usually not recommended except for topical antibiotic drops for the first four months of life. Nasolacrimal massage, which must be vigorous and frequent, can be disruptive to the parent and child bonding process, and is frequently unnecessary.

The exception to this is a mucocele or amniocele of the nasolacrimal sac that presents as a very firm bluish mass over the inner canthal area. Mucoceles and amnioceles appear in the first two weeks of life and are often unresponsive to massage. Because they tend to become infected, causing a periorbital cellulitis, they may need to be probed early.

Source: ncbi

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