Clinical Diagnosis And Management Of Congenital NLDO

Nasolacrimal duct obstruction occurs approximately in 5% of newborns which is a blockage of the lacrimal drainage system. In the majority of children, the major causes of NLDO are congenital. The blockage is more common to occur at the Hasner valve which is located at the distal end of the duct. The blockage can be unilateral as well as bilateral. 

The nasolacrimal duct sac is filled with clear amniotic fluid from birth mad become purulent within the days of birth and the neonatal dacryocystitis occurs. Children with Down syndrome, cranisynostosis, golden hair sequence, clefting syndromes, hemifacial microsomia, or any midline facial anomaly are mostly at the higher risk of congenital NLDO. 


The signs of nasolacrimal duct obstruction involve the increased tear lake, mucous or mucopurulent discharge, and epiphora. The skin around the eye or periocular skin is chapped sometimes and the globe is usually white. There is mucoid reflux and mucopurulent material from the punctum when pressure is applied. 

When the mucocele starts becoming infected and dacryocystitis occurs, the area starts to swelling and erythema in the lacrimal sac with palpable sac. This mass can be decompressed sometimes with the digital pressure resulting in the purulent material coming out through the lacrimal puncta. If the condition is severe the rupturing of the abscessed sac through the skin can occur. 

A fluorescein dye disappearance test is the one which is mostly recommended by the Best eye doctor in peer Muchalla and is the most useful option in confirming the diagnosis of nasolacrimal duct obstruction.


General Treatment includes the initial observation for the probing issues which can be treated with aggressive surgical procedures. 

Medical therapies like lacrimal massages and treatment with topical antibiotics are on the list of recommendations of the Best eye doctor in Dhakoli.

Medical follow-up of the patient is necessary to tackle the growth of the condition. It can also help in restraining further issues from occurring. 

Surgery is important and the primary treatment includes duct probing. The success rate for a simple probing can be declining with the increasing age of the children. 

According to the Best eye doctor in peer Muchalla – NLDO affects a lot of children from birth but can be treated. Early treatment increases the rate of success in the surgery and the more the treatment is delayed, the rate can be decreased as well.

Clinical Diagnosis And Management Of Congenital NLDO
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