When Your Newborn Infant Isn't Making Tears While Crying

Infant Vision Q&A: Eye Conditions That May Affect Normal Tear Production

Mom calming a crying baby in her arms
Images By Tang Ming Tung/Getty Images

Q. My daughter is three months old today and she still does not have tears. She cries and nothing comes out... Is this normal and if so could you tell me when they should develop tears? Ashley, Hapeville, GA

A. Not making tears is rarely a true medical problem for infants, especially since you don't mention other symptoms.

Newborns start making tears when they are about two weeks old, but often it is just enough to keep their eyes moist and not enough to make real tears that you can see when they cry.

Infants often don't develop real tears that you can see until they are about seven or eight months old.

Eye Problems in Newborns and Infants That Can Affect the Production of Tears 

If your baby truly wasn't making any tears, then her eyes would likely be very red, dry, and irritated. This could be caused by a problem with the tear glands (the lacrimal glands) or the lacrimal ducts that carry the tears to the eye. In that case, you would want to see a Pediatric Optholmologist as soon as possible for an evaluation.

On the other hand, if your baby has tears when not crying, then a blocked duct may be to blame. This may correct itself on its own, but any swelling, redness or pus may indicate and infections and seeing the doctor immediately is still strongly recommended. Some of the eye problems that can interfere with normal tear production and development in newborns, infants and toddlers include:

Blocked Tear Ducts (Dacryostenosis). A narrowing or blockage of the tear ducts which drain tears from the eye into the nose can cause tear build up. You will most likely notice an increase in tears which run down your child's face.

Pink Eye (Conjunctivitis​). Red eye in a newborn can be caused by an infection, a blocked tear duct or by irritation.

The condition is most dangerous when caused by an infection.

Cataracts. When there is a clouding of the lens of the eye, the condition may need surgery to remove the cataract. A baby can be born with cataracts or develop it later. 

Strabismus (Crossed Eyes). This condition usually occurs in people with poor eye muscle control or farsightedness. A misalignment of the eyes in babies is usually a condition called pseudostrabismus—or false strabismus. As your baby's face grows, the appearance of crossed eyes will usually go away.

Amblyopia (Lazy Eye). Decreased vision in one or both eyes may require treatment for the stronger eye (most often with patching or eyedrops) to train the amblyopic (weak) eye to be stronger.

Glaucoma. Symptoms of childhood and congenital (present at birth) glaucoma include excessive tearing, cloudy eyes, fussiness and sensitivity to light. Elevated eye pressure, damage to the optic nerve, and potential vision loss are all concerns for children exhibiting symptoms of glaucoma.

Retinoblastoma. A rare type of cancer, symptoms of this condition can include a white pupil reflex (the pupil should normally be red when light is shined upon it, but instead the pupil appears white or pink), vision problems, redness and pain.


American Optometric Association. Strabismus (Crossed Eyes). Accessed 2 April 2016.

American Association for Pediatric Ophthalmology and Strabismus. Amblyopia and Cataracts. Accessed 2 April 2016.

Glaucoma Research Foundation. Glaucoma Can Strike At All Ages, Even Newborn Babies. Accessed 2 April 2016.

American Cancer Society. Retinoblastoma. Accessed 2 April 2016.

Center for Disease Control and Prevention. Conjunctivitis (Pink Eye) in Newborns. Accessed 2 April 2016.

Continue Reading