Dr. Victor Pegado

Pediatrics, Strabismus, Cataract & Comprehensive Ophthalmology


Blocked Tear Ducts
At-Home Dilation


If your child is prescribed glasses, it is very important for your child to wear them and look through them, especially while patching.

If the frames are too loose on your child, have an optician adjust the fit. In addition, many places sell bands that the optician will place on each temple of the frame to create a snugger fit. This means your child has no way to look over them.

For further information on appointments for glasses, please review the FAQ.


In a child’s eye, if the vision is not used in both eyes during the critical period of visual development, (usually between birth and age 7 years) amblyopia will develop. Amblyopia is loss of vision that will be permanent if it is not corrected before visual maturity (around age 7 years). The way to treat this is by patching the better eye. This forces the brain to use the weaker eye and actually improves the vision.

Tips: Helping your child adjust to the eye patch

  • Patching reduces depth perception; take care with outdoor activities.
  • Decorate the patch! Drawings, stickers, etc. make patching a fun ritual.
  • Positive reinforcement is always key. Try to associate patching with engaging activities and your positive attention.
  • In the beginning, sit with your child so they don’t feel alone in a “blurry world.”
  • Have the teacher seat your child in the front of the classroom.
  • Use bribery, sticker charts, or other positive reward systems.
  • For younger children who may not understand other methods, consider gentle physical restraints (socks on the hands, water wings at the elbows, etc. may hinder removal of the patch).
  • Try putting the patch on early in the morning before your child has gotten up. This will dull your child’s comparison of good vision and poorer vision, and they may not notice the patch as much.
  • Be consistent.

The first thirty minutes of patching each time are the hardest. Try to entertain your child during this time with one on one attention or provide sufficient distraction.

Blocked Tear Ducts

When the pathway that normally carries tears from the eye to the nose is blocked, it is called a blocked tear duct. This happens often in very young babies. Most of the time, only one tear duct is blocked at a time.

Your child may have a blocked tear duct when:

  • One eye is always watery.
  • Tears run down the face even when your baby does not cry.
  • When crying, the nostril on the blocked side is still dry.
  • The eye on the blocked side is not red, and the eyelid is not swollen.
  • The problem starts before your child is 1 month old.

Although the blockage was present at birth, your baby may not have symptoms right away. This is because in some babies, tear production is sometimes delayed until 3 or 4 weeks of age.

How long does it last?

This is a common condition, affecting 6% of newborns. Both sides are blocked 30% of the time. Over 90% of blocked tear ducts open up spontaneously by the time a child is 1 year old. If the blockage continues after age 1 year, an ophthalmologist (eye specialist) can open it with a probe.

How can I take care of my child?

Massage the lacrimal sac (where tears collect) twice a day to empty it of old fluids. Always wash your hands carefully before doing this. The lacrimal sac is in the inner, lower corner of the eye. Start at the inner corner of the eye and gently press upward, using a cotton swab. A small amount of clear fluid should come out.

Because of poor drainage, eyes with blocked tear ducts become easily infected. The infected eye produces a yellow discharge. If the eye becomes infected, it is very important to begin antibiotic eyedrops and to stop the massage.

At-Home Dilation

Cyclopentolate or Atropine eye drops are temporarily used to relax the focusing muscles of your child’s eyes. These drops will dilate the eyes (the pupil/black part of the eyes will enlarge). This allows Dr. Pegado to see the back of the eye and examine the overall health of the eyes, as well as aids in performing an accurate refraction (glasses check).


  • You will be given a small, one-time-use eye drop to take home.
  • We ask you to instill this drop in your child’s eyes at least 40 minutes prior to their next appointment with Dr. Pegado.
  • One or two drops can be instilled into each eye. Do this by pulling down the lower eyelid and squeezing the drop into the lower eyelid pocket that is created.
  • It is normal for these eye drops to sting for a few minutes.
  • It is safe to repeat the installation if you are not sure the drops went in.
  • Try not to let the dropper touch the eye; this could cause injury to the surface of the cornea.

These drops will make your child light sensitive; objects can appear blurry for up to 24 hours.

Drops should be stored in a cool, dark place out of your child’s reach. Please dispose of any unused drops.