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One of the most common causes of watering eye in children is congenital nasolacrimal duct obstruction (CNLDO), which signifies a delay in the maturing of the nose and lacrimal system. Other causes of epiphora include congenital atresias and some craniofacial disorders.

At birth, 50% of nasolacrimal ducts are still not patent. Spontaneous perforation occurs rapidly in the first three to four weeks, meaning that only a few infants have symptomatic epiphora and/or stickiness after birth. Up to 96% of these cases resolve in the first year without intervention, a further 60% resolving in the second year, after which organic resolution continues more slowly.

Sufferers can therefore present with watering eyes during the first days of life, which can cause chronic conjunctival infection, mucous discharge, eyelid dermatitis, or even acute infections in the lacrimal sac known as acute dacryocystitis.

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