A rare association of blepharophimosis–ptosis–epicanthus inversus case with congenital nasolacrimal duct obstruction

2019 ◽  
pp. 112067211988642 ◽  
Author(s):  
Nishi Gupta ◽  
Suma Ganesh ◽  
Poonam Singla ◽  
Sunil Kumar
Keyword(s):  
Light Transmission ◽  
Genetic Defect ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Nasal Bridge ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Inferior Meatus ◽  
Flat Nasal Bridge ◽  
Membranous Part

Purpose: The aim of reporting this case is to describe a rare combination of blepharophimosis–ptosis–epicanthus inversus syndrome with congenital nasolacrimal duct obstruction. A variety of lacrimal anomalies have been seen in blepharophimosis–ptosis–epicanthus inversus syndrome but the occurrence of nasolacrimal duct obstruction is rare. Method: The blepharophimosis–ptosis–epicanthus inversus syndrome is an autosomal dominant rare genetic defect with clinical manifestation of dysplasia of the eyelids, palpebral fissures, flat nasal bridge, and ptosis. A 20-month-old boy was referred with the complaints of watering and discharge from his right eyes since birth. On examination, the child had all the features of blepharophimosis–ptosis–epicanthus inversus syndrome with right congenital nasolacrimal duct obstruction in line with the published reports. Result: On endoscopic probing and irrigation, the probe could not be visualized into the inferior meatus. On dacryoendoscopy, the membranous part of the nasolacrimal duct was found to be completely obliterated with no light transmission into the nose indicating a malformed nasolacrimal duct. The child was managed by endoscopic dacryocystorhinostomy. We could find only one case report published so far on the combination of congenital nasolacrimal duct obstruction with blepharophimosis–ptosis–epicanthus inversus syndrome. This study adds one more case of blepharophimosis–ptosis–epicanthus inversus syndrome with congenital nasolacrimal duct obstruction and adjuvant use of dacryoendoscopy.

Usefulness of high definition sialoendoscope for evaluation of lacrimal drainage system in congenital nasolacrimal duct obstruction

2021 ◽  
pp. 112067212110080
Author(s):  
Nishi Gupta ◽  
Poonam Singla ◽  
Suma Ganesh
Keyword(s):  
Light Transmission ◽  
Drainage System ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
High Definition ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Lacrimal Drainage System ◽  
Membranous Obstruction ◽  
Lacrimal Drainage

Purpose: Sialoendoscope was used as a dacryoendoscope, high- definition images of the lacrimal drainage system (LDS) were captured and its performance in congenital nasolacrimal duct obstruction (CNLDO) is reported. Methods: Nasal endoscopy was done as the first in all the cases using a 0°, 2.7 mm nasal endoscope (Karl Stroz Tutlingan Germany). This was followed by Dacryoendoscopy (DEN) of the lacrimal drainage system from puncta till the valve of Hasner. DEN was performed under general anaesthesia in 26 children (including 17 primary and 9 failed probing cases). All cases were examined using 0.8 mm sialoendoscope (Karl Storz, Tuttlingen, Germany) with fibreoptic light transmission with a side port for irrigation. Results: We were able to obtain high-definition images of canaliculi, lacrimal sac, sac duct junction, proximal, mid and distal segments of nasolacrimal duct in all the children with CNLDO. In 17 primary cases 16 had distal membranous obstruction and I case had proximal canalicular obstruction. In nine children with history of failed probing, five had membranous obstruction, two had dacryoliths, two had NLD malformation at different levels. An overall success rate of 88.4% was achieved. Conclusion: Sialoendoscope can be used as high-definition dacryoendoscope for diagnostic and therapeutic use in CNLDO. Useful information can be obtained on dacryoendoscopy in complex CNLDO cases.

Conventional or Endoscopic Probing for Congenital Nasolacrimal Duct Obstruction

2001 ◽  
Vol 11 (3) ◽  
pp. 215-217 ◽  
Author(s):  
M. Orhan ◽  
P. Çal ◽  
M. Önerci ◽  
M. Írkeç
Keyword(s):  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Direct Visualization ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Inferior Meatus ◽  
Endoscopic Guidance ◽  
Age Range

Purpose To compare conventional and endoscopic probing for congenital nasolacrimal duct obstruction in infants. Methods Conventional probing was performed in 22 eyes of 18 patients, age range 7–14 months (mean 11.4 months). Probing was done with intranasal endoscopic visualization in 18 eyes of 14 patients, age range 7–13 months (mean 11.2 months). All were primary probing cases. Results After conventional probing 2 of the 22 cases required reprobing. After endoscopic probing only 1 of the 18 cases required reprobing. Conclusions In most cases of congenital nasolacrimal duct obstruction endoscopy is not required; however, in failed cases direct visualization of the inferior meatus with endoscopic guidance may be helpful.

Spontaneous resolution rates in congenital nasolacrimal duct obstruction managed with massage or topical antibiotics compared with observation alone

2021 ◽  
pp. bjophthalmol-2021-318853
Author(s):  
Brian G Mohney ◽  
Saraniya Sathiamoorthi ◽  
Ryan D Frank
Keyword(s):  
Medical Records ◽  
Population Based ◽  
Nasolacrimal Duct ◽  
Spontaneous Resolution ◽  
Nasolacrimal Duct Obstruction ◽  
Olmsted County ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Topical Antibiotics

Background/aimsTo determine if nasolacrimal massage or topical antibiotics are associated with higher rates of resolution compared with observation alone in a population-based cohort of infants with congenital nasolacrimal duct obstruction (CNLDO).MethodsThe medical records of all children <5 years diagnosed with CNLDO while residing in Olmsted County, Minnesota from 1 January 1995 through 31 December 2004 were retrospectively reviewed for type of management and non-surgical resolution of tearing.ResultsAmong 1958 infants diagnosed and followed for CNLDO, 516 (26.4%) were merely observed, 506 (25.8%) were prescribed massage alone, 485 (24.8%) were prescribed at least one course of topical antibiotics, 397 (20.3%) were prescribed both topical antibiotics and massage, and 54 (2.8%) had no documented therapy. Non-surgical resolution, occurring in 1669 (85.2%) during a median follow-up of 3.1 months (range: 1 week–248 months), was 74.6% for the merely observed, 89.7% for those prescribed digital massage, 87.0% for those prescribed antibiotics and 90.7% for those treated with both. This comparison was significant in unadjusted (p<0.001) and multivariable comparisons (p<0.001).ConclusionPrescribing topical antibiotics or digital massage for infants with CNLDO in this cohort, individually or in combination, was associated with a higher rate of spontaneous resolution than observation alone.

scholarly journals Resolution of congenital nasolacrimal duct obstruction with conservative management

2017 ◽  
Vol 6 (1) ◽  
pp. 12-15
Author(s):  
J B Shrestha
Keyword(s):  
Congenital Anomaly ◽  
Conservative Management ◽  
Pediatric Population ◽  
Clinical Signs ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Topical Antibiotics ◽  
Appropriate Treatment

Congenital nasolacrimal duct obstruction is the commonly encountered congenital anomaly in pediatric population occurring in as many as 30% of new borns. Conservative management of such condition with topical antibiotics and properly performed massage of the nasolacrimal sac is appropriate treatment during the first few months of age. The purpose of this study was to determine the rate of resolution of nasolacrimal duct obstruction with conservative management in infants up to 10 months of age. A total of 181 infants of age up to 10 months old with the diagnosis of Congenital nasolacrimal duct obstruction were advised nasolacrimal duct massage with or without the prescription of topical antibiotics. Resolution of nasolacrimal duct obstruction was assessed at 3 month and 6 month and was defined as the absence of all clinical signs of nasolacrimal duct obstruction. At the 6-month examination, 163 eyes (83%) of 181 children showed resolution with conservative management. The overall success rate of Congenital nasolacrimal duct obstruction with conservative management was high and this form of management can be considered as one of the best options in infants.

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