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Examination (watery eye in infant)

Authoring team

Examination:

  • examine vision and ocular function
  • vision - tested by slow pursuit movements e.g. in response to face or toy
  • eye is generally white; some conjunctival hyperaemia is acceptable
  • cornea should be clear and normal size with sharp iris detail
  • corneal reflexes are central
  • red reflexes present

  • any signs supportive of lacrimal duct obstruction
    • such as a thick tear film that often overflows, a swelling at the inner canthus (secondary to a lacrimal sac mucocele)

  • look for mimics of lacrimal duct obstruction
    • lid or lash abnormality
    • chlamydial conjunctivitis - typical is a sticky eye and a plushy hyperaemic appearance of the lower lid conjunctiva - can continue to over 8 months in age - if in doubt take chlamydia swabs

BMJ (1997), 315, 293-6.


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