J Korean Ophthalmol Soc.  2008 Oct;49(10):1559-1564.

The Characteristics of Infants with Congenital Nasolacrimal Duct Obstruction Iimproved with Lacrimal Sac Digital Massage

Affiliations
  • 1Department of Ophthalmology, Pochon CHA University College of Medicine, Pundang CHA Hospital, Sungnam, Korea. eye@cha.ac.kr

Abstract

PURPOSE
The treatments for congenital nasolacrimal duct obstruction range from minimally invasive to more invasive methods. Initially, clinicians select lacrimal sac massage with topical antibiotics application or early lacrimal sac probing. We studied if the characteristics of infants improved after lacrimal sac massage with topical antibiotic application.
METHODS
Two hundred thirty-four eyes of 204 patients diagnosed with congenital nasolacrimal duct obstruction from March 2001 to January 2007 were included. Excluded were infants who had obvious epiblepharon or eyelid abnormalities, tumors of the lacrimal system, or a history of trauma. Neonates less than 1 month were also excluded to rule out neonatal conjunctivitis. At the first visit, we recorded birth profile information such as gestational age, birth weight and height, onset time of symptoms, and post-conceptional age. We compared the results between the successful treatment group and failure group after lacrimal sac massage and topical antibiotic application.
RESULTS
One hundred twenty-three eyes showed improvement after conservative treatment (52.6%), and the infants included in the success group visited earlier and had lower PCA (P<0.05). No other factors evaluated in this study contributed toward the improvement in symptoms observed.
CONCLUSIONS
When considering treatment for congenital nasolacrimal duct obstruction, an evaluation of factors related to birth should be performed. According to the results, infants with the characteristics of favorable outcome should be treated conservatively, while those patients who do not have the characteristics for favorable outcome should be treated by early probing to achieve an effective and satisfactory outcome.

Keyword

Congenital nasolacrimal duct obstruction; Lacrimal sac massage; Probing

MeSH Terms

Anti-Bacterial Agents
Birth Weight
Conjunctivitis
Eye
Eyelids
Gestational Age
Humans
Infant
Infant, Newborn
Massage
Nasolacrimal Duct
Parturition
Passive Cutaneous Anaphylaxis
Anti-Bacterial Agents

Figure

  • Figure 1. Crigler method lacrimal sac massage. (A) Apply eye ointment around the lacrimal fossa for lubrication. (B) Compress the common canalicular area with index finger. (C) Take the finger down while compressing strongly.


Reference

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