Congenital Nasolacrimal Duct Obstruction

Abstract

Congenital nasolacrimal duct obstruction (CNLDO) is a common cause of epiphora in children with incidence of symptoms ranging from 1.2 to 30 % [1, 2]. However the incidence of anatomic nasolacrimal duct obstruction seen in stillborn is much higher at around 73 %. It is believed that respiratory efforts, crying, and sucking create negative pressure within the nose which helps to break the membrane present at the nasolacrimal duct (NLD) opening. This spontaneous perforation usually occurs by 3–4 weeks of age, but if it fails, manifestations of CNLDO are seen [3]. Management of CNLDO is principally guided by natural history of the disease and high spontaneous remission rate by 1 year of age [2]. The standard of care now for non-resolving cases is endoscopic-assisted probing with or without intubation. There is an increasing role of dacryoendoscopy and simultaneous correction of associated intranasal abnormalities [4, 5].