Abstract
Congenital nasolacrimal duct obstruction (CNLDO) is a common condition causing excessive tearing or mucoid discharge from the eyes, due to blockage of the nasolacrimal duct system. Nasolacrimal duct obstruction affects as many as 20% children aged <1 year worldwide and is often resolved without surgery. Available treatment options are conservative therapy, including observation, lacrimal sac massage and antibiotics, and invasive therapy. Observation, combined with conservative options, seems to be the best option in infants aged <1 year. Meanwhile, in children aged >1 year, nasolacrimal probing successfully addresses most obstructions. However, the most favorable timing for probing remains controversial. To alleviate persistent epiphora and mucous drainage that is refractory to probing, repeat probing, silicone tube intubation, balloon catheter dilation or dacryocystorhinostomy can be considered as available treatment options. Our review aims to provide an update to CNDO management protocols.
Highlights
Congenital nasolacrimal duct obstruction (CNLDO) is a common disorder in the pediatric population, causing failure in the nasolacrimal duct drainage system and presenting clinically in the overflow of tears, called “epiphora” [1].Epidemiological studies report that the prevalence of CNLDO ranges from 5% to 20% in the early phase of childhood [2,3]
Investigative Group (PEDIG) studied the cost-effectiveness of immediate office-based NLD probing in comparison with a 6-month period of conservative management followed by deferred facility-probing in a sample size of 163 children with CNLDO aged 6 to 10 months
A more recent study found a statistical difference in the resolution rate of CNLDO in infants effectively treated with regular lacrimal sac massage in comparison with observed infants and infants that did not have frequent lacrimal sac massages (96.2% vs. 77.7%, p = 0.001) [30]
Summary
Aldo Vagge 1,2, *, Lorenzo Ferro Desideri 3 , Paolo Nucci 4 , Massimiliano Serafino 4 , Giuseppe Giannaccare 5 , Andrea Lembo 4 and Carlo Enrico Traverso 1,2.
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