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Congenital nasolacrimal duct obstruction
Pediatric Ophthalmology
Key Points
- •CNLDO is caused by an imperforate membrane at the valve of Hasner and is the most common cause of epiphora in infants, affecting 6–20% of newborns
- •Up to 96% resolve spontaneously by 12 months - Crigler massage (firm downward strokes over lacrimal sac, 10 strokes 2–3x daily) is the cornerstone of conservative management
- •Probing is indicated when conservative management fails by age 12–15 months; first probing success rate is 80–90%
- •Dacryocystocele presents as a blue-grey medial canthal swelling at birth and may cause respiratory distress from intranasal cyst extension
- •The conjunctiva is characteristically white and quiet in CNLDO - conjunctival injection suggests alternative diagnoses (neonatal conjunctivitis, congenital glaucoma)
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Keep reading Congenital nasolacrimal duct obstruction
17 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations