Every morning I have to clean yellow pus and mucus from my eight-week-old daughter's eyes. The public health nurse checked and says there is no sign of infection and it could be a problem with her tear glands.
I'm a first-time mother and I'm worried as to whether this is a serious problem.
As a nurse has examined your baby's eyes and has reassured you there is no sign of infection, the problem could be the result of a blockage in the tear ducts rather than the glands.
Tears are produced in the lacrimal glands which lie just above the eyeballs. The glands manufacture a thin film of fluid which covers the eyes and lubricates and protects them.
The tears are then drained away by two very small drainage ducts which are located on the inside corner of the eye next to the nose.
These lead to a much wider duct known as the nasolacrimal duct which drains into the back of the nose.
Why do blockages occur? My mother says she remembers me having the same problem. Is there a family link?
Yes, there is. The commonest cause is inherited narrowing of the very fine ducts. It usually becomes evident that one or both eyes are affected in infants between the ages of three and 12 weeks.
The signs and symptoms are excessive watering with mucus and the presence of pus on waking. This either clears up over time or may progress to become infected, in which case there will be redness or swelling of the surface of the eye.
If the tear duct is infected, a red painful swelling appears between the inner corner of the eye and the nose.
In some cases an infant's eyes may water and discharge soon after birth as a result of the tear ducts failing to open.
If it doesn't clear up by itself, what can be done about it?
In the majority of cases the problem resolves by itself as a result of the tear ducts growing. This usually occurs around the age of six months and onwards.
You can also help with gentle massage from the inner corner of the eye to the outer tip of the nose. Make sure you wash your hands and use your little finger in gentle but firm strokes.
However, if the problem is severe and repeated infections occur, then conjunctivitis can develop and will require antibiotic drops or ointment.
If the problem has not settled by 12 months, the ducts can be probed and dilated under anaesthetic. In a tiny minority of cases an artificial duct may be needed.