## **Core Concept**
The clinical presentation described for the 2-week-old infant, including excessive tearing, overflow of tears, and the presence of mucoid material, is suggestive of a condition affecting the nasolacrimal duct. The nasolacrimal duct is responsible for draining tears from the eye into the nasal cavity. In infants, a common issue is the failure of the nasolacrimal duct to fully canalize or open, leading to a condition known as **nasolacrimal duct obstruction (NLDO)**.

## **Why the Correct Answer is Right**
The symptoms described—excessive tearing (epiphora), overflow of tears onto the lower eyelid, and the presence of mucoid material—are classic for nasolacrimal duct obstruction. This condition often presents in the first few weeks of life due to a membranous obstruction at the distal end of the nasolacrimal duct. The most appropriate next step in management for a child of this age with uncomplicated NLDO is usually conservative, involving **nasolacrimal duct massage**. This technique helps to relieve the obstruction by promoting the rupture of the membranous blockage at the valve of Hasner.

## **Why Each Wrong Option is Incorrect**
- **Option A:** While probing of the nasolacrimal duct may eventually be required if conservative measures fail, it is not typically the first line of treatment, especially in infants as young as 2 weeks, due to the risks associated with the procedure.
- **Option B:** Although antibiotic eye drops might be considered if there is suspicion or evidence of secondary infection (infection of the conjunctiva or eyelids), the primary issue here appears to be NLDO rather than an infectious process.
- **Option C:** This option seems to suggest no intervention or a delay in addressing the issue, which is inappropriate given the symptoms could lead to complications like dacryocystitis (infection of the lacrimal sac).

## **Clinical Pearl / High-Yield Fact**
A key point to remember is that nasolacrimal duct obstruction is a common cause of epiphora in infants, and initial management involves **nasolacrimal duct massage**. The technique involves using the index finger to massage the area over the nasolacrimal duct (from the inner canthus down towards the nasal ala) several times a day. This simple, non-invasive approach can resolve the obstruction in many cases.

## **Correct Answer:** D. Nasolacrimal duct massage.