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Infants, Tears and Crying

Question of the Week

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Updated February 25, 2008

Q. My daughter is three months old today and she still does not have tears. She cries and nothing comes out... Is this normal and if so could you tell me when they should develop tears? Ashley, Hapeville, GA

A. I once had a patient who was five years old before he first had tears. When I asked him why, he said that he never had anything to cry about before. { Just kidding }

Not to make light of a possible medical problem, but not making tears is rarely a true medical problem, especially since you don't mention other symptoms.

Newborns start making tears when they are about two weeks old, but often it is just enough to keep their eyes moist and not enough to make real tears that you can see when they cry. Infants often don't develop real tears that you can see until they are much older and about seven or eight months old.

If your baby truly wasn't making any tears, then her eyes would likely be very red, dry, and irritated. This could be caused by a problem with the tear glands (the lacrimal glands) or the lacrimal ducts that carry the tears to the eye. In that case, you would want to see a Pediatric Optholmologist as soon as possible for an evaluation.

Other eye problems that infants can have include:

  • blocked tear ducts (dacryostenosis), with increased tearing
  • pink eye
  • cataracts, with clouding of the lens of the eye
  • strabismus, misalignment of the eyes
  • amblyopia, the loss of vision in an eye
  • glaucoma, with excessive tearing, cloudy eyes, fussiness and sensitivity to light
  • retinoblastoma, with a leukocoria or a white pupil reflex

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