4yo not producing tears??

[Honeymoonmummy]

Hi all, I've noticed in the last week or so that DD, 4, doesn't produce any tears when she cries anymore. This afternoon she had a complete meltdown and no tears. I don't think this was put on for show, she was clearly genuinely upset. I thought it might be blocked tear ducts but just had a read of NHS online and it seems the opposite is usually true if someone has blocked tear ducts. The eyes are not red / sore. kAnyone got any ideas? Could it be dehydration?

If she was that dehydrated you'd have realised long before now. It's more likely she just having a strop rather than a boo-hoo?

If you are concerned she isn't producing any tears, get her checked out at the GPs.

My ds2 had low tear production - that we were unaware of - at the same age, which led to some damage to the surface of his eyes. He didn't have red, itchy or sore eyes and it was only picked up when we were at the eye department at the hospital for something unrelated.

He had artificial tear drops several times a day for a year or so, but the problem improved as he got older. He is nearly 9 now and still doesn't produce 'floods of tears' when upset, but hasn't needed the drops for a couple of years.

No, it was more than a strop Brain. That's interesting Moose, now I think on I wonder if its related to an incident in summer when she got a load of sand kicked in her eyes at close range. I'm going to take her to the GP on Monday, see what they say.

Has she ever had tears? My DS (aged 10) has never shed tears. We asked a GP about it when he was younger who said that he was producing enough moisture to clean his eyes. He just wasn't producing it as a response to pain or emotion. It's not caused him any problems, although when he was younger I did mention it to new teachers so they would know he wasn't faking it if he cried!

An Ophthalmologist can examine her for dry eyes and any signs of corneal dystrophies if you get concerned. A high street Optometrist (optician) can also have a first look at the tear film and the eye surface, and a chat. One sign is whether she has pool of tear along the lower eyelid margin (meniscus). With the standard yellow dye fluorescein they can see the tear film and how it moves on blinking.

GPs don't have ophthalmoscopes but refer into hospital Eye Clinics. Children with unresolved dry eyes are seen in tertiary referral eye clinics.

My d is at GOS now for chronic dry eye but the cause is blepharitis (see NHS website blepharitis, dry eye). We use a warm flannel in the bath with warm sterile water to keep the eyes good but this is because her meibomian glands were blocked. The first signs were overtearing (epiphora) and photophobia. Hypersensitivites and allergies can be a factor in meibomian gland dysfunction, eg we use hypoallergenic detergents and have eliminated artificial perfumes and are careful about possible allergens in the house.

It's probably fine, but that's your worst case scenario - get it checked though!

Eicosapentaenoic, my ds suffers from blepharitis and blocked mebomian glands as well, resulting in recurrent, severe chalazion on both lids from the age of 3.

We tried everything, but the only thing we found that worked for him in the end was LidClear solution, unfortunately they discontinued it and only sell the wipes now which are £££s.

Every single time he developed a chalazion he would end up with an infection and that often led to cellulitis, so they used to have to give him antibiotics at the first hint of one developing.

He has mostly outgrown it, but it does recur to some extent in the summer, which we assume is due to a hayfever type allergy. He used to start school every September with a massive chalazion, but hasn't had any for a couple of years now and the blepharitis hasn't returned either.

He's now on a maintenance routine of lid cleansing every couple of days and daily in the summer, which seems to be working for him.

Thanks guys, the problem is she completely freaks out whenever anyone goes near her eyes, we had a nightmare getting the sand out, I had to do it with cotton bud cos she wouldn't let nurse do it. I can't see her letting them do the yellow thing at the opticians. She actually got upset last night and I did see a couple of tears so she is producing some but nowhere near as much as she used to I'm sure. I'll take her to opticians tomorrow (first day off since I started thread) and see what they say. Thanks all