Unilateral congenital nasolacrimal duct obstruction and amblyopia risk factors

Abstract

IntroductionThis study aimed to investigate the prevalence of amblyopia risk factors in patients with unilateral congenital nasolacrimal duct obstruction (CNLDO).Patients and methodsA retrospective interventional case series was performed on all consecutive patients of unilateral CNLDO who underwent probing over a 6-month period in 2017. All patients underwent a complete ocular examination, retinoscopy, axial length measurements and keratometry. Risk factors for amblyopia were noted based on the American Association for Pediatric Ophthalmology and Strabismus guidelines. The fellow eye of the patients with CNLDO was taken as an internal control. Statistical analysis was performed using Stata version 13.0 statistical software. A p-value of ≤0.05 was considered statistically significant.ResultsOne hundred eyes of 50 patients were studied. The median age at presentation was 36 months without any gender predisposition (M: 26, F: 24). All patients presented with symptoms of epiphora. Seven (14%) of the patients were noted to have amblyopia risk factors: five (10%) were secondary to refractive errors and two (4%) had congenital cataracts. The anisometropia noted in the five patients showed the worse eye to be the one with CNLDO in all the cases. The common refractive error noted was a compound hyperopic astigmatism in three eyes followed by mixed astigmatism and simple hyperopia in one eye each.ConclusionThe prevalence of amblyopia risk factors in children with unilateral CNLDO is marginally higher than that reported in general population. Hence, a thorough evaluation should be carried out to detect amblyopia risk factors and for their prompt management.

Success rates of probing for congenital nasolacrimal duct obstruction at various ages

“…Abundant lacrimal meniscus and mucopurulent discharge which persists on the surface of the cornea may lead to blurring of vision and interferes with the clear focusing of images on the retina, which is critical for emmetropization [22]. Several authors have confirmed an increased risk for anisometropia and amblyopia in patients with CNLDO (especially long-term untreated obstructions) [22][23][24][25]. However, the effect of long-term epiphora on visual development in children is debatable and some studies reported no significant differences between children with CNLDO and general population [17,26,27].…”

Monocanalicularis szilikonsztent implantációja könnycsatorna-elzáródással született gyermekekben

“…A könnyelvezetés zavara nemcsak állandó diszkomfortérzést okoz a páciensnek, hanem látásromlást is előidézhet. Egyes tanulmányok szerint elhanyagolt vagy fel nem ismert esetben hosszú távon irreguláris astigmiához, illetve tompalátás kialakulásához vezethet a szemrésben megrekedt könny, hiszen sokszor a látásfejlődés legérzékenyebb időszakában változtathatja meg a fénytörést a magas könnytócsa [3][4][5][6][7]. Mások azonban megkérdőjelezik az epiphora okozta deprivatiós amblyopia kialakulásának lehetőségét, mivel a korban megfelelő átlagpopulációhoz képest a könnyező páciensek között nem találtak nagyobb arányban tompalátókat [8,9].…”