Initial Management of Pediatric Lower System Problems: Probing and Silicone Stents and Balloons

Abstract

Congenital nasolacrimal obstruction can present in a variety of ways. The most common problem is an obstruction at the end of the nasolacrimal duct, but the site of stenosis or obstruction can occur anywhere along the outflow pathway for draining tears. While conservative management consisting of massage and appropriate topical antibiotics can work in the majority of cases, surgical intervention is sometimes required. This chapter will summarize the most effective methods for managing lower tear system outflow problems which involve the structures inferior to the puncta, canaliculi, and lacrimal sac.