Congenital nasolacrimal duct (NLD) obstruction
- = congenital dacryostenosis
- Epidemiology
- m/c cause of eye discharge in infants
- Pathophysiology
- Incomplete canalization of distal nasolacrimal duct
- Hasner’s valve? ?? ???? 6%?? ?????, 90%? 1? ? ?? ??.
- Clinical features
- Increased tearing
- Eyelash crusting
- Clear conjunctivae
- Diagnosis
- Typically diagnosed clinically.
- Fluorescein dye testing
- Indicated for patients with tearing and additional findings concerning for a corneal abrasion (eg, facial scratches, photophobia, pain)
- Dye that persists and flows down the cheek, rather than draining through the NLD, supports the diagnosis.
- Management
- Observation for spontaneous resolution
- Lacrimal sac massages
- Probing of duct if persists >6 months
- ??? ??? -> probing ? silicone tube
- Complications
- Dacryocystocele
- Dacryocystitis
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