Management of congenital nasolacrimal duct obstruction.

Abstract:

:Our review aims to provide an update of management protocols for congenital nasolacrimal duct obstruction (CNDO). Although early probing performed before the age of 1 year was traditionally recommended, many reports have since confirmed high frequencies of spontaneous resolution during the first year of life. Accordingly, a 'wait-and-see' approach, combined with conservative therapies, is judged to be the best option in infants aged<1 year. By contrast, persistent obstruction beyond 1 year of age warrants probing as a first-line interventional therapy. However, the optimal timing for probing remains controversial. Although there remains a high possibility of spontaneous resolution after the first year of age, this must be balanced against the decrease in success rates for probing that accompanies advancing age. If conservative management fails, persistent CNDO beyond 1 year of age should be managed either by further observation or by primary probing according to the severity of symptoms. In patients in whom probing fails, advanced treatment such as balloon catheter dilation, silicone tube intubation or dacryocystorhinostomy may be considered.

journal_name

Acta Ophthalmol

journal_title

Acta ophthalmologica

authors

Takahashi Y,Kakizaki H,Chan WO,Selva D

doi

10.1111/j.1755-3768.2009.01592.x

subject

Has Abstract

pub_date

2010-08-01 00:00:00

pages

506-13

issue

5

eissn

1755-375X

issn

1755-3768

pii

AOS1592

journal_volume

88

pub_type

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