Pediatric nasolacrimal duct obstruction

Abstract

The decision to probe early in the office or continue medical management and probe beyond a year of age in a facility with a general anesthetic is at the discretion of the ophthalmologist. Failed probings should be treated in a facility under general anesthesia with a balloon catheter or intubation. Children with congenital nasolacrimal duct obstruction need to be followed to make certain they do not develop anisometropic amblyopia.

Nasolacrimal duct intubation in the treatment of congenital nasolacrimal duct obstruction in older children

“…1 The obstruction is usually at the level of the Hasner valve, at the distal end of the duct. 1 Fortunately, spontaneous resolution occurs in most of the cases by the age of 1 year. 2 Probing has been found to have high success rates in the treatment of cases whose obstruction does not resolve spontaneously.…”

Congenital Nasolacrimal Duct Obstruction

“…Age at which probing is indicated is debated in literature but is usually after 6 months of age [ 19 ]. Early probing usually done between 6 and 9 months of age is an offi ce procedure practiced by some which avoids general anesthesia and is done under topical anesthesia and restraint.…”

Congenital Nasolacrimal Duct Obstruction and the Visual System

“…Approximately 90% infants with CNLDO experience spontaneous resolution before the age of 1 year. It becomes symptomatic in merely 5-6% of infants [4]. Probabilities of spontaneous resolution by 12 months of age are 80-90%, at 3 months of age, 68-75%, at 6 months of age, and 36-57% at 9 months of age [5].…”