Congenital nasolacrimal duct obstruction occurs when the thin membrane at the end of the tear drainage duct has not opened at birth. It is very common in newborns and most cases resolve spontaneously within the first year.
Signs and symptoms
- Persistent watering of the eye
- Crusting of the lashes, eyelids stuck together in the morning
- Recurrent eye infections
- Swelling and redness at the inner corner — should be assessed without delay
Diagnosis
Diagnosis is made by examination and the fluorescein dye disappearance test. Because children with unilateral obstruction can have a difference in refraction between the eyes, a refraction should also be performed.
Treatment options
- Massage and hygiene
- Correctly performed lacrimal sac massage and keeping the eye area clean.
- Medication
- Appropriate antibiotic drops if there are signs of infection.
- Probing
- Opening the duct with a fine probe when it does not resolve on its own.
- Silicone intubation
- Temporary silicone tube placement for recurrent or complex cases.
Frequently asked questions
When should probing be done?
It is usually recommended around 1 year of age if massage and observation have not helped. Probing can also be successful in older children; the decision is based on examination findings.
The information on this site is general and does not replace an examination, diagnosis or treatment.