scholarly journals Conservative Treatment for Congenital Nasolacrimal Duct Obstruction – Factors Affecting the Success

2021 ◽  
Vol 48 (2) ◽  
pp. 25-28
Author(s):  
K. P. Valcheva ◽  
S. V. Murgova

Abstract Aim To examine the success rate and factors affecting the effect of conservative treatment for congenital nasolacrimal duct obstruction (CNLDO) in children. Methodology A prospective study was made on 167 eyes of 131 patients with clinical signs of CNLDO. All of them were initially treated nonsurgically with Crigler massage. The curative effect of this management was evaluated on the basis of no history of watery eyes, negative regurgitation test, and dye disappearance test 0 or 1 grade. Exploratory analyses assessed whether baseline characteristics including age, gender and laterality were associated with the probability of CNLDO resolving without surgery. If the nonsurgical treatment failed, probing was done in the Eye Clinic in Pleven. Results The conservative treatment for CNLDO with Crigler massage was successful in the majority of treated cases – in 115 out of 167 eyes with CNLDO (68,9%). The remaining 52 (31,1%) eyes were probed. Age (p = 0,001) and laterality (p = 0,001) were found to be associated with resolution of the clinical signs. Conclusions Nonsurgical management for CNLDO was successful initial treatment in patients with this pathology. The Crigler massage was more effective in children up to 12 months of age with unilateral obstruction.

2017 ◽  
Vol 6 (1) ◽  
pp. 12-15
Author(s):  
J B Shrestha

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.


2015 ◽  
Vol 63 (10) ◽  
pp. 759 ◽  
Author(s):  
Sahil Bhandari ◽  
Sabyasachi Sengupta ◽  
Dayakar Yadalla ◽  
Jayagayathri Rajagopalan ◽  
GirishBharat Velis ◽  
...  

2020 ◽  
pp. 1-4
Author(s):  
N. V. N Prasanna Bharathi ◽  
P. Ramdas ◽  
M. Padma ◽  
Sowmya Andole

AIM: To study and evaluate the different organisms that are responsible for congenital nasolacrimal duct obstruction .To initiate appropriate antimicrobials based on the sensitivity patterns of the isolated organisms. Methods: It is a prospective study conducted in Sarojini Devi Eye hospital during September 2016 to February 2018. 112 samples from 100 cases were collected from clinically diagnosed congenital nasolacrimal duct obstruction with epiphora below 1 year without any ocular and systemic diseases .Swabs taken were analysed for causative microorganisms of congenital nasolacrimal duct obstruction. Results: In our study out of 112 samples[88 unilateral cases+12 bilateral cases ]82 cases [73.21%] were culture positive, of which80 [71.42%]were bacterial,2 cases [1.78%]were mixed [ bacterial +fungal].Gram positive bacteria were predominant, staphylococcus epidermidis 56[68.29%] followed by Staphylococcus aureus 13[15.85%].Among gram negative bacteria Escherichia coli 1 [1.21%], klebsiella 1[1.21%]. 2 cases were mixed [bacteria +fungal]. Infection is more commonly seen in right eye. Rate of infection was higher in females 62[55.35].Higher incidence of infection was seen in the age group of less than 7 months. Both gram positive and gram negative were most susceptible to tobramycin. Conclusion: Among all the congenital nasolacrimal duct obstructions 90% of the cases would resolve spontaneously with medical therapy and Criggler massage. 10 % of the cases require probing and silicon tube intubation. The knowledge of identification , awareness and bacteriology of congenital nasolacrimal duct obstruction by the paediatricians , physicians and the parents would contribute to the choice of effective antimicrobials and reduce keratitis medicamentosa ,induced astigmatism due to excessive eye rubbing and apprehension among the parents.


2019 ◽  
Vol 30 (6) ◽  
pp. 1228-1231
Author(s):  
Mehmet Fuat Alakus ◽  
Umut Dag ◽  
Selahattin Balsak ◽  
Seyfettin Erdem ◽  
Hasan Oncul ◽  
...  

Purpose: The aim of this study was to research the relationship between types of birth and congenital nasolacrimal duct obstruction. Method: The study enrolled 665 infantile patients with prediagnosis of congenital nasolacrimal duct obstruction due to associated ophthalmic symptoms. Age, gender, family history, delivery type, and patient medical records were investigated. Patients were grouped and compared according to their birth type and whether it was the first birth. Results: The number of the infants with and without congenital nasolacrimal duct obstruction was 227 (34.1%) and 438 (65.9%), respectively. Comparison of the congenital nasolacrimal duct obstruction and non-congenital nasolacrimal duct obstruction groups according to the first births showed that ratio of cesarean section was significantly higher in the congenital nasolacrimal duct obstruction group than the non- congenital nasolacrimal duct obstruction group (58.7% and 20.7%, respectively). Number with positive family history also was significantly higher in the congenital nasolacrimal duct obstruction group. Conclusion: Cesarean section in first birth and positive family history of congenital nasolacrimal duct obstruction appear to be important risk factors in the etiopathogenesis of congenital nasolacrimal duct obstruction.


Folia Medica ◽  
2019 ◽  
Vol 61 (1) ◽  
pp. 97-103 ◽  
Author(s):  
Krasina P. Valcheva ◽  
Snezhana V. Murgova ◽  
Emilia K. Krivoshiiska

Abstract Aim: To determine the success rate of initial and repeated probing for congenital nasolacrimal duct obstruction (CNLDO) in children between 2-41 months. Patients and methods: One hundred and twelve children aged 1.8 to 13 years responded to the control examination. They were diagnosed with CNLDO in the past and now included in a retrospective study. The mean follow-up period was 5.2 years (from 0.6 to 11.6 years). Patients were divided into two groups according to their age at the time of surgery: group A (2-12 months) and group B (13-41 months). Probing and irrigation of NLD was performed in the Eye Clinic in Pleven under general anesthesia in all subjects. A controlled examination was done to evaluate the effect of probing on the basis of a history of watery eyes, regurgitation test, and dye disappearance test (DTT). Results: Of the 131 eyes in 112 children, 110 eyes (84%) had one probing and 21 eyes (16%) had repeat probing. Success rate of the initial probing was 90% (99 of 110) for all patients’ eyes: 89% (70 of 79) in group A and 94% (29 of 31) in group B. The cure rate of the repeat probing was 76% (16 of 21) for all patients: 88% (7 of 8) in group A and 69% (9 of 13) in group B. The overall success rate of probing was 88% (115 of 131). Conclusion: Nasolacrimal duct probing followed by irrigation is a commonly performed, highly successful treatment for congenital nasolacrimal duct obstruction in children. The success rate for initial and repeated nasolacrimal duct probing is not affected by age.


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