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The natural process of congenital nasolacrimal duct obstruction and effect of lacrimal sac massage

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Abstract

This study aimed to examine the rate of symptomatic improvement of congenital nasolacrimal duct obstruction (CNLDO) in infants treated with conservative management within the first year of age. Other purpose of the study is to emphasize the relationship between spontaneous resolution time and effective lacrimal sac massage. Thirty-one infants were diagnosed to have CNLDO by an ophthalmologist prior to 3 months of age. In this study, 36 eyes of 31 patients were included with CNLDO. The patients were divided into two groups. Group 1 (28 eyes of 24 patients) was consisted of the patients who were applied effective lacrimal sac massage regularly during the follow-up period, and patients whose parents did not apply a regular lacrimal passage regularly were accepted as group 2 (8 eyes of 7 patients). Thirty-three eyes of 31 patients (18 rights and 15 left) successfully resolved with only conservative management (91.6 %). In these thirty-three eyes, one eye (3 %) resolved between 0 and 3 months, fourteen eyes (42.5 %) resolved between 4 and 6 months, eleven eyes (33.3 %) resolved between 7 and 9 months, and seven eyes (21.2 %) resolved between 10 and 12 months. CNLDO was resolved in 27 (96.2 %) of 28 eyes in group 1, and in group 2, six eyes (77.7 %) had resolvement. This difference was statistically significant (p = 0.001). The mean age of resolution was 6.8 ± 1.88 months in group 1, 10.3 ± 1.5 months in group 2 (p < 0.001). In light of our study, we believe that conservative management of CNLDO is highly successful. Our study provided a possible objective explanation for the efficacy of lacrimal sac massage. Emphasizing the importance of the massage to parents and describing in detail can reduce the risk of unnecessary surgical interventions.

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References

  1. Caputo GM, Appelbaum PC, Liu HH (1993) Infections due to penicillin-resistant pneumococci. Clinical, epidemiologic, and microbiologic features. Arch Intern Med 153(11):1301–1310

    Article  CAS  PubMed  Google Scholar 

  2. Cassidy TC (1952) Developmental anatomy of the nasolacrimal duct. Arch Ophthalmol 47(2):141–158

    Article  Google Scholar 

  3. Crigler LW (1923) The treatment of congenital dacryocystitis. JAMA 81:23–24

    Article  Google Scholar 

  4. Kakizaki H, Takahashi Y, Kinoshita S, Shiraki K, Iwaki M (2008) The rate of symptomatic improvement of congenital nasolacrimal duct obstruction in Japanese infants treated with conservative management during the 1st year of age. Clin Ophthalmol 2(2):291–294

    Article  PubMed  PubMed Central  Google Scholar 

  5. Kerstein RC (1996). Congenital lacrimal abnormalities In: Principles and practice of ophthalmic plastic and reconstructive surgery. W B Saunders Company. 2 731–747

  6. Kodsi S (2006) Community-acquired methicillin-resistant Staphylococcus aureus in association with chronic dacryocystitis secondary to congenital nasolacrimal duct obstruction. J AAPOS 10(6):583–584

    Article  PubMed  Google Scholar 

  7. Kushner BJ (1982) Congenital nasolacrimal system obstruction. Arch Ophthalmol 100(4):597–600

    Article  CAS  PubMed  Google Scholar 

  8. MacEwen CJ, Young JDH (1991) Epiphora during the first year of life. Eye 5(Pt 5):596–600

    Article  PubMed  Google Scholar 

  9. MacEwen CJ, Phillips MG, Young JD (1994) Value of bacterial culturing in the course of congenital nasolacrimal duct (NLD) obstruction. J Pediatr Ophthalmol Strabismus 31(4):246–250

    CAS  PubMed  Google Scholar 

  10. Nelson LR, Calhoun JH, Menduke H (1985) Medical management of congenital nasolacrimal duct obstruction. Ophthalmology 92(9):1187–1190

    Article  CAS  PubMed  Google Scholar 

  11. Noda S, Hayasaka S, Setogawa T (1991) Congenital nasolacrimal duct obstruction in Japanese infants: its incidence and treatment with massage. J Pediatr Ophthalmol Strabismus 28(1):20–22

    CAS  PubMed  Google Scholar 

  12. Nucci P, Capoferri C, Alfarano R, Brancato R (1989) Conservative management of nasolacrimal duct obstruction. J Pediatr Ophthalmol Strabismus 26(1):39–43

    CAS  PubMed  Google Scholar 

  13. Paul TO (1985) Medical management of congenital nasolacrimal duct obstruction. J Pediatr Ophthalmol Strabismus 22(2):68–70

    CAS  PubMed  Google Scholar 

  14. PEDIG (2012). A randomized trial comparing the cost-effectiveness of 2 approaches for treating unilateral nasolacrimal duct obstruction. Arch Ophthalmol; 130(12):1525–1533

  15. Peterson RA, Robb RM (1978) The course of congenital obstruction of the naso-lacrimal duct. J Pediatr Ophthalmol Strabismus 15(4):246–250

    Google Scholar 

  16. Piest KL, Katowitz JA (1991) Treatment of congenital nasolacrimal duct obstruction. Ophthalmol Clin North Am 4:201–209

    Google Scholar 

  17. Robb RM (2001) Congenital nasolacrimal duct obstruction. Ophthalmol Clin North Am 14(3):443–446

    Article  CAS  PubMed  Google Scholar 

  18. Welham RAN, Hughes SM (1985) Lacrimal surgery in children. Am J Ophthalmol 99(1):27–34

    Article  CAS  PubMed  Google Scholar 

  19. Jensen OL, Gluud BS (1985) Bacterial growth in the conjunctival sac and the local defence of the outer eye. Acta Ophthalmol 63:80–82

    Article  Google Scholar 

  20. Mannis MJ (1997) Bacterial conjunctivitis. In: Tasman W, Jaeger EA (eds) Duane’s clinical ophthalmology. JB Lippincott, Philadelphia, pp 1–7

    Google Scholar 

  21. Usha K, Smitha S, Shah N, Lalitha P, Kelkar R (2006) Spectrum and the susceptibilities of microbial isolates in cases of congenital nasolacrimal duct obstruction. J AAPOS 10(5):469–472

    Article  PubMed  Google Scholar 

  22. Gerkowicz M, Koziol-Montewka M, Pietras´-Trazpiel M, Kosior- Jarecka E, Szczepanik A, Latalska M (2005) Identification of bacterial flora of conjunctival sac in congenital nasolacrimal duct obstruction in children. Klin Oczna 107(1–3):83–85

    PubMed  Google Scholar 

  23. Kuchar A, Lukas J, Steinkogler FJ (2000) Bacteriology and antibiotic therapy in congenital nasolacrimal duct obstruction. Acta Ophthalmol Scand 78(6):694–698

    Article  CAS  PubMed  Google Scholar 

  24. Bareja U, Ghose S (1990) Clinicobacteriological correlates of congenital dacryocystitis. Indian J Ophthalmol 38(2):66–69

    CAS  PubMed  Google Scholar 

  25. Kim YS, Moon SC, Yoo KW (2000) Congenital nasolacrimal duct obstruction: irrigation or probing. Korean J Ophthalmol 14(2):90–96

    Article  CAS  PubMed  Google Scholar 

  26. MacEwen CJ, Phillips MG, Young JD (1994) Value of bacterial culturing in the course of congenital nasolacrimal duct (NLD) obstruction. J Pediatr Ophthalmol Strabismus 31(4):246–250

    CAS  PubMed  Google Scholar 

  27. Young JDH, MacEwen CJ (1997) Managing congenital lacrimal obstruction in general practice. BMJ 315(7103):293–296

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Zwaan J (1997) Treatment of congenital nasolacrimal duct obstruction before and after the age of 1 year. Ophthalmic Surg Lasers 28(11):932–936

    CAS  PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Ophthalmology, Bozyaka Training and Research Hospital, Çatalkaya Mah, Gunaydın sok, Zümrütevler Sitesi, No: 1/8 Narlıdere, Izmir, Turkey

    Omer Karti, Durgul Acan & Tuncay Kusbeci

  2. Department of Ophthalmology, Sifa University, Izmir, Turkey

    Eyyup Karahan

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  1. Omer Karti
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  2. Eyyup Karahan
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  3. Durgul Acan
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  4. Tuncay Kusbeci
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Correspondence to Omer Karti.

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Karti, O., Karahan, E., Acan, D. et al. The natural process of congenital nasolacrimal duct obstruction and effect of lacrimal sac massage. Int Ophthalmol 36, 845–849 (2016). https://doi.org/10.1007/s10792-016-0208-5

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  • DOI: https://doi.org/10.1007/s10792-016-0208-5

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