Tears are secreted by a gland situated above the eye. Tears protect, clean, and humidify the eye. Tears are eliminated by evaporation, by rolling down the cheeks and also by the naso-lacrymal system, which is situated in the corner of the eye close to the base of the nose. This system is composed of little tubes, which recover and transport the tears and communicate directly with the nose cavity. This explains why your nose is runny when you cry.
At birth, 30% of infants have obstruction of the canalization of the tear drainage system, however only 2 to 4% become symptomatic. This obstruction of the nasolacrimal duct is called, in medical terms, congenital nasolacrimal duct obstruction (CNLDO).
The consequence of this obstruction is insufficient tear drainage, which leads to an overflow of tears onto the eye and/or mucus discharge either spontaneously or by pressing the lacrymal sac in the corner of the eyes.
The cause of this obstruction (partial or total) could be an immaturity of tissue development and/or a congestion of the nasolacrymal system.
Intrauterine life & birth: the first trauma of the life
During pregnancy, there is stress applied on the fetus’ skull and face due to the intrauterine position. Even when a normal birth appears to be completely trauma free, the compression on the baby’s skull and face during birth can alter the tissue quality and the circulation of the face. All of this strain, can lead to a disruption of optimal functioning of the nasolacrymal system.
How an Osteopath can help you?
First of all, there is a remarkably high rate of spontaneous resolution (>90%) during the first 12 months of life. However osteopathic care can help to resolve this problem as soon as possible and improve the comfort of the baby but also to avoid infection and repetitive cleaning by the parents.
At birth and during the first months, the bones of your baby’s skull are not welded, therefore the skull is flexible and deformable. This deformability is necessary to allow the skull to pass through a small space (i.e. the pelvis). However, if the compressive forces of birth are too important, the skull bones may not be able to fully re-expand to their normal size after the birth.
The osteopathic treatment consists to check the mobility and flexibility of the skull in order to allow the nasolacrymal system to work correctly on a mechanical, neurological and circulatory level. This canal is located between 2 bones of the face: maxillar sup and ingus. Of course, it will be important to ensure the good mobility of the whole body (joints, organ, fascia, membranous). Your Osteopathic Manual Practitioner uses gentle manual techniques to treat infants and will provide advice on how to perform lacrymal sac massage (Crigler massage) and indications about frequency.
Usually, one to three osteopathic sessions can be adequate to fix the problem. In any case, it’s always valuable to try osteopathy before doing other more invasive therapies, like a probing procedure, which can require anesthesia.
Before seeing an Osteopathic Manual Practitioner, it’s important to consult your physician in order to eliminate another pathology that could have the same symptoms and signs as a blocked tear duct.
In osteopathy, there are many causes that can lead to “a blocked tear duck” in infants, and it is always over-simplistic to write an article because each newborn is unique. This article aims solely to explain this problem and how osteopathy can help you and your baby.
- Bahram Eshragi, Masoud Aghsaei Fard, Babak Masomian, Mohammadreza Akbari . Probing for Congenital Nasolacrimal Duct Obstruction in Older Children. Middle East Afr J Ophthalmol. 2013 Oct-Dec; 20(4): 349–352.
- MacEwen CJ, Young JD, Barras CW, Ram B, White PS. Value of nasal endoscopy and probing in the diagnosis and management of children with congenital epiphora. Br J Ophthalmol. 2001 Mar;85(3):314-8.
- Perchepied G. Etude des effets du traitement ostéopathique sur l’obstruction du canal lacrymal chez le nourrisson. Mémoire d’ostéopathie, Rennes, Institut de Formation Supérieure en Ostéopathie de Rennes. 2012
- Posadzki P, Lee MS, Ernst E. Osteopathic manipulative treatment for pediatric conditions: a systematic review. Pediatrics. 2013 Jul;132(1):140-52. doi: 10.1542/peds.2012-3959. Epub 2013 Jun 17. Review.
- Navarro JP, Capo i Giner JV. Efficacy of the osteopathic technique of lacrimalis bone release in children with congenital naso- lacrimal duct obstruction. Osteopatia Cientifica. 2009;4(3):79–85
For more information on Osteopathic Medicine, contact us for a complimentary 15 minute consultation. Call 416-792-4400 today to schedule your consultation or appointment!