Newborns don't shed tears because their tear ducts haven't fully formed. After a couple months, their tear ducts are usually in working order but about 50% of babies have 'clogged ducts' for some period of time. Clogged ducts is the completely confusing medical jargon way of saying that the drainage part of the tear ducts, the little tubes that go from the inside bottom corner of the eye to the sinuses, haven't opened up. Usually they aren't actually clogged with something so much as the little valves that are in the duct to prevent nose stuff from coming out the eye (gross!) are stuck shut or there is a little membrane over the duct that hasn't broken open yet. Fixing the problem is as simple as just showing the valve how to open or breaking the thin membrane. About 90% of babies clogged ducts clear up within the first 12 months because they rub their own eyes. In fact, the initial 'treatment' for clogged ducts is for parents to rub the babies eye (and to squirt some breast milk in there to help prevent infection).
Around his first month we noticed Simon had clogged ducts. In February (~7 months) his left eye finally gave in and the ducts opened up on their own, but the right side has remained clogged. This is bad because tears and mucous normally secreted by the eye don't have a drainage path. This causes extra tearing, but in Simon the big problem is that his eyes get goopy with big eye boogers and when he's sleeping his eye gets crusted shut. It makes his little cheek chapped from the constant tears and us wiping away the goop and waking up with an eye that won't open is scary. Sometimes his eye also gets red and irritated with a little infection.
The risk of doing nothing and leaving the duct to clear itself is that an infection could cause real damage. There is a surgery that opens the valves, it's really simple if done before 12 months. Surgery to open clogged ducts after the one year mark becomes much more complicated and the success rate drops dramatically the longer the surgery is delayed. While surgery is never really desirable, the general practice is that if the baby's ducts haven't opened on their own by 9 to 10 months they see an eye specialist with a goal of doing a surgery around the 11 month mark. That gives the eye as much time as possible to unclog on its own but still is within the high success rate of surgery under 12 month mark. For the surgery up to a year, a small wire is inserted into the tear duct to open it up. It's that simple and takes about 5 minutes tops. The only complicated thing is that the baby has to be under anesthesia.
We have scheduled the surgery for Simon's right eye for Wednesday May 2nd. He'll be 10 and a half months old (so big!). It is an out patient surgery so we'll be home on Wednesday afternoon. We'll let you know how it all goes, but I expect it to be straightforward.
