Pediatric Eyelid Problems, Eye Socket Disease and Tearing

Pediatric eyelid problems, eye socket disease and tearing issues are rather common and require expert care. Children aren’t just little adults, and need a physician with experience in treating their unique anatomy. Ophthalmic plastic surgeons, like Dr. Harris, are experts in treating many of these disorders and are available to assist in caring for your kids.


Excess tearing from the eye is not uncommon in children. The tear drain is located in the inner corner of the eyelids and runs into the nose. Unfortunately about 5% of infants are born with a congenital blockage of the tear drain. When this is present, babies will develop excess tears dripping from the eye along with occasional discharge from the eye and crusting along the lashes. The good news is 90% of these blockages open spontaneously during the first year of life. During this time period conservative treatment with massaging the tear system and topical antibiotics are the mainstay of treatment. If the problem continues beyond the first year of life or if a severe infection occurs during the first year of life, a surgical procedure can be performed to open up the tear drain, which is highly successful. Sometimes extra procedures are needed like placing a stent or stretching the tear drain with a balloon to help establish normal flow down the drain.

Congenital Ptosis (droopy eyelid) and Eyelid Abnormalities

The eyelids function to protect the health of the eye. However if an eyelid does not form properly it can have an effect on visual development. A congenital droopy eyelid, Ptosis, most commonly occurs because the muscle inside the eyelid that lifts the lid did not former properly. The weakness in the eyelid muscles can be mild and often observed or it can be profound and need urgent surgery to prevent significant visual problems. The only viable treatment for a droopy eyelid is surgery to lift the eyelid. Multiple surgical techniques exist to accomplish this and are tailored to meet the needs of the child based on the severity of the droopy eyelid and the amount of function the muscle inside the eyelid has.

In addition to ptosis of the eyelid, other problems can affect the eyelid and its function. This includes in turning or out turning of the lid, misdirected eyelashes, congenital defects of the eyelid and even growth in the lid or superficially in the skin of the eyelid. Again, the importance of treating these problems and restoring normal eyelid function is to ensure the health of the eye and development of normal vision.

Child before and after repair of congenital ptosis

Orbital Disease

Thankfully, orbital problems are not that common in children. The orbit is the boney socket in the skull that houses the eye and all the associated structures that help the eye function. The most common problem to affect the eye socket in children is acute bacterial infections, most commonly spreading from an adjacent sinus infection. These serious infections require aggressive treatment with antibiotics and sometimes surgery. In addition, tumors of the eye socket occur as well. Hemangiomas are an over growth of blood vessels that grow rapidly in the first year of life then slowly regress. When present in the orbit or eyelids, it can seriously affect visual function and development. In addition, some cancers can occur around they eye in children. A combination of surgery, chemotherapy and sometimes radiation is used to treat these life threatening problems.

Finally, kids love to have fun but sometimes at the cost of injuring themselves. Injury to the eye, orbit and surrounding structures often heals with careful observation and rest. However more serious injuries may necessitate surgery to repair the damage.

Who Should Perform Pediatric Oculoplastic Surgery?

When choosing a surgeon to evaluate and treat pediatric oculoplastic problems that involve the eyelid, tear drain or orbit, look for an ophthalmic facial plastic & reconstructive surgeon who specializes in the eyelids, orbit, and tear drain surgery. Dr. Call and Dr. Harris have the extra training required to care for these problems in children and adults. They are not only board certified ophthalmologists who know the anatomy and structure of the eyelids and orbit, but also have expertise in ophthalmic plastic reconstructive surgery to appropriately care for your child. Contact us today.