Bilateral Lacrimal Sac Swelling in a Newborn

A term male newborn develops a painful bilateral swelling over both lacrimal sacs with purulent ocular discharge. A 5-day-old male newborn presents to the emergency department with bilateral mucopurulent ocular discharge and is given a topical antibiotic. On the following day, he develops a painful bilateral swelling over both lacrimal sacs. No fever, nasal obstruction, or respiratory difficulty are present. According to the mother, he had a blueish coloration of both medial canthal regions since birth. ### Physical Examination