Counsel a family on a sticky watering eye and teach Crigler massage — OSCE

Communication tasks

Open by acknowledging the parents' worry and confirming what they have noticed, then explain the diagnosis in plain language: the tear-drainage tube that runs from the eye into the nose has not finished opening at the lower end, so the tears and a little mucus build up and overflow rather than draining away. Reassure them that the eye itself is healthy — it is white and quiet, the vision is normal, and the red reflex is clear — so the watering is a plumbing problem, not an infection or a sight problem. [4]

Explain why antibiotic drops are not the answer: the stickiness is stagnant tears and mucus, not an infection, and drops neither speed the opening nor prevent the stickiness from returning. Instead, teach the Crigler massage: place a clean finger over the inner corner of the eye by the nose, press firmly downward against the bone for about ten strokes, three or more times a day with each feed or nappy change, and wipe the discharge away with a clean damp cloth. The pressure helps pop the persistent membrane open and empties the stagnant sac. [4]

Share the reassuring natural history: most cases open on their own within the first year, so patience and massage are the plan for now. Set the review at around twelve months, and explain that if the watering is still troublesome then, a short, generally straightforward procedure called probing opens the tube — usually very successfully — and that the timing balances waiting for natural resolution against the fact that the procedure is more successful when done earlier. [5] [2]

Close with a clear, written safety-net: bring the baby back immediately if the eye becomes red or swollen, if a tender lump appears at the inner corner with a fever, if the baby starts screwing the eye shut or avoiding the light, or if the watering is suddenly much worse. Each of these is a different problem that needs prompt review, not the usual blocked duct. Invite questions, confirm understanding, and arrange the follow-up. [4]