What is the common cause of watering of eyes in infancy and how is it managed?

Infants with a nasolacrimal duct obstruction present with a watery eye and an increased tear lake, mattering of the eyelashes, and mucus in the nasal corner of the eyelids. This is due to improper canalization of the nasolacrimal duct pathway (which drains tears from the eyes to the nose). Congenital nasolacrimal duct obstruction is common and occurs in 1 to 5% of the population, with approximately 1/3 occurring in both eyes. Medical management during the observational period (initial six months of age) is a combination of nasolacrimal sac massage and intermittent topical antibiotics. In case the lacrimal massage fails to open the obstruction, syringing and probing is done. Under sedation or general anesthesia, a small steel wire is passed through the punctum into the nasolacrimal system, and down out into the nasal cavity. This does not hurt, nor does it create any problem in the nose. The success rate for a single nasolacrimal duct probing is approximately 90%. It might need repeat sittings to relieve the nasolacrimal obstruction. In cases where nasolacrimal duct probing fails, intubation with silicone tubes is indicated to establish a working system. In case the above procedures don’t provide relief, the child may require a dacryocystorhinostomy (DCR) procedure at around 3.5 to 4 years of age. This involves making an alternate bypass between the tear drainage system and the nasal cavity