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Type: Journal article
Title: Management of congenital nasolacrimal duct obstruction
Author: Takahashi, Y.
Kakizaki, H.
Chan, W.
Selva-Nayagam, D.
Citation: Acta Ophthalmologica, 2010; 88(5):506-513
Publisher: Wiley-Blackwell Munksgaard
Issue Date: 2010
ISSN: 1755-375X
Statement of
Yasuhiro Takahashi, Hirohiko Kakizaki, Weng O. Chan and Dinesh Selva
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.
Keywords: congenital nasolacrimal duct obstruction
conservative treatment
primary probing
spontaneous resolution
surgical intervention
Rights: © 2009 The Authors. Journal compilation © 2009 Acta Ophthalmol
DOI: 10.1111/j.1755-3768.2009.01592.x
Appears in Collections:Aurora harvest 5
Opthalmology & Visual Sciences publications

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