Crigler Massage for Congenital Blockade of Nasolacrimal Duct.

Abstract

To determine the success rate of non-surgical management of congenital nasolacrimal duct obstruction (CNLDO) with Crigler massage in infants below the age of one year. A cross-sectional observational study. Department of Ophthalmology at HBS General Hospital, Hazrat Bari Sarkar Medical and Dental College, Islamabad from November 2015 to May 2016. One hundred children with watering of eyes, due to congenital blockage of the distal part of the nasolacrimal duct (at the valve of Hasner), unilateral or bilateral were included in the study. Initially, Crigler massage was advised to all the parents for a period of 1-3 months with practical demonstration and the results were documented every fortnight. There were 52 infants up to the age of 6 months and 48 infants between 6-12 months, 53% were boys and 47% were girls. Among them, 67% had unilateral complain while 33% were bilaterally affected. At the end of 1-3 months, 90% of the children achieved patency and only 10% of the cases were subjected to Bowman's probing under short anesthesia. CNLDO mostly resolved through conservative approach by Crigler massage as an initial management, if done consistently. Probing and other surgical procedures should not be considered before the age of 12 months.