Parents have been asking me eye-opening questions about their children’s tears. This week let me tear or “tear” though some information on this topic.

Glands under your upper eyelids produce tears – the moisture that then washes down and over your eyes. Usually tears drain out through tear ducts, tiny tubes that connect your eyes to your nose, like a drain. (They are located near the inside corner of each eye.)

Sometimes the flow of tears increases to the point where you can’t drain the moisture through the tear ducts quick enough. We all know a little about when that happens and why. Either you’re laughing… or you’re crying and tears flow out and onto your face.

It’s important, however, to know there is a reason for eyes to water or tear up even when not crying. Tears can help protect your eyes, keeping them moist and washing out any dirt, dust or other small particles. For example, smoke contains particles too small to see, but big enough to irritate the eye and produce tears.

What about an onion? The fumes the onion gives off also contain chemicals that irritate the surface of the eye and produce tears. Wind? It can dry the surface of the eye, which results in tears to keep the surface moist and protected. Allergies or infections? An allergic trigger or a germ releases chemicals that irritate the eye. Again, tear ducts produce tears to irrigate the eye and clean those irritants out.

Sometimes tears happen because the tear duct is blocked. This is common in about one third of babies. There is often excessive tearing with pus or crusting over the eye when an infant wakes from sleep. Such blockage will usually open on its own. You can also massage the area on the inside of the eye gently to try to open the tear ducts. What if there is no improvement after several months or recurrent infections occur requiring antibiotics? A minor operation can open up the tear ducts. The results are usually excellent.

Hopefully, tips like these will make you misty when it comes to knowing a little bit more about tears.

Lewis First, MD, is chief of Pediatrics at The University of Vermont Children’s Hospital and chair of the Department of Pediatrics at the Robert Larner, M.D. College of Medicine at the University of Vermont.  You can also catch “First with Kids” weekly on WOKO 98.9FM and MyNBC 5, or visit the “First with Kids” video archives at

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