Nasolacrimal Duct Obstruction

Nasolacrimal Duct Obstruction

Definition: Watering from the eyes of a child is most commonly caused due to blockage of nasolacrimal duct that drain      tears from the eye to the nose.

The red dot in the image on the left shows the common area where the block is usually found.

 

The child would present with

  1. Watering and Sticking of eyes: This can be confirmed by applying green colored dye (Fluorescin) that gets retained in the eye and doesnot get drained in the duct.
  2. Swelling (as shown in the pictures below)
  3. Fistula (Abnormal passage of tears)

Treatment:

1)     Nearly 90-95 % children have complete resolution with Antibiotic eye drops and lacrimal massage  within  1 year of age.

 

If this condition is not resolved beyond 1 year of age it can cause infections that can spread into the eye or into the brain

Treatment:

1)      Antibiotic eye drops and lacrimal massage may help to cure the diseased if preformed within  1 year of age.

2)      For children more than 1 year, 3 surgical procedures are available

  • Simple Probing: Probing is a very safe, effective and short procedure that can easily open up the blocked ducts in 1-2 mintues….more Watch video link
  • Probing with infracture / silastic tubes: For patients who had one failed probing or older children >4 years or children with Down’s syndrome, simple probing procedure does not cure the condition with high success. At Jyotirmay eye clinic, we possess special equipments (Ritleng intubation / Crawford intubation with retriever / Pediatric Nasal endoscope / Smart probes etc) to cure this condition with 70-80% success rate. This procedure can avoid a major surgery in those patients.
  • Dacryo cysto rhinostomy: A child with bony block or older children (>6 years) are the best candidate for this procedure.

What is special at Jyotirmay Eye Clinic?

  1. We use smart lacrimal probes invented by us that increase the success and reduce the bleeding
  2. We use Sevoflurane anesthesia to perform the entire surgery within a couple of minutes
  3. We use Nasal Endoscope to ensure near 100% success rates

Watch two Videos of Smart Probe for Smarter Probing


Balloon Dacryocystoplasty:

This is a novel method to treat complex nasolacrimal duct obstruction or CNLDO in older children >6 years with or without silicon intubation. The procedure is simple and the overall success rate is 70%. If combined with silicon intubation the success rate increase to 90%.

To watch the video – click below

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Last updated 8th May, 2017
The individual solely responsible for the content of this site is – Dr Mihir Kothari, an experienced, qualified and senior pediatric eye surgeon, squint specialist and nystagmus specialist who is an ardent researcher.
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Dr Mihir Kothari

Director, Jyotirmay eye clinic

drmihirkothari@jyotirmay.com