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PubMedDate not supplied

Can congenital nasolacrimal-duct obstruction interfere with visual development? A cohort case control study.

PURPOSE: To ascertain if tear film disturbance in congenital nasolacrimal-duct obstruction (CNLDO) interferes with visual maturation. METHODS: Review of a cohort of children in which the occurrence and duration of CNLDO had been previously documented. Information obtained included acuity, refractive data, and presence or absence of strabismus. The incidence of abnormality in the CNLDO group was compared with that in controls, which were fellow eyes in those children with unilateral obstruction, and all children with no history of CNLDO. RESULTS: Of 4792 children, visual acuity data were obtained on 2249. There was no difference in the incidence of amblyopia in CNLDO children compared with controls (p < 0.89) nor in the watering eye compared with the fellow eye (p < 0.58). No correlation between refractive error or astigmatism and CNLDO (p < 0.26 and p < 0.32 respectively) was found. Strabismus was no more common in CNLDO than in controls (p < 0.89). CONCLUSIONS: This study found no evidence to suggest that visual maturation is adversely affected by allowing spontaneous resolution of CNLDO.

Amblyopia↗
PubMed2001

Clinicopathologic analysis of 166 patients with primary acquired nasolacrimal duct obstruction.

OBJECTIVE: To determine the prevalence of lacrimal sac pathology in patients undergoing dacryocystorhinostomy (DCR) for primary acquired nasolacrimal duct obstruction (PANDO). DESIGN: Observational case series. PARTICIPANTS: One hundred sixty-six patients with symptoms of PANDO. METHODS: A total of 202 lacrimal sac biopsies were obtained from 166 patients undergoing external DCR procedures for symptoms of PANDO. MAIN OUTCOME MEASURES: Patient demographics, presenting symptoms and signs, relevant history, and assessment of the nasolacrimal system were recorded. All lacrimal biopsy specimens were examined histopathologically. RESULTS: A total of 118 patients (71%) were female and 48 patients (29%) were male. The mean age was 60.7 years (range, 21-93 years). All patients demonstrated epiphora, and 32 patients had dacryocystitis. Duration of symptoms ranged from 6 weeks to 50 years. No lacrimal sac tumors were detected. Sixty-five percent of specimens demonstrated chronic inflammation. CONCLUSIONS: No neoplasms were detected among 202 lacrimal sac specimens from 166 patients with symptoms of PANDO. Most lacrimal sac specimens demonstrated chronic inflammatory changes. We conclude that a lacrimal sac biopsy should be performed when there is suspicion of a neoplasm based on the clinical, historical, or intraoperative findings, rather than routine biopsy of all patients with PANDO.

Adult↗
PubMed1997

The anatomy of probing and irrigation for congenital nasolacrimal duct obstruction.

In this study, an easily palpable landmark, the supraorbital notch or foramen, was used to simplify the localization of the nasolacrimal duct during the probing procedure. The notch was palpated in 50 patients of a pediatric clinic. The topographic anatomy of the notch in relation to the lacrimal drainage system was studied in 10 skulls. The supraorbital notch is a convenient landmark for the guidance of a probe into the nasolacrimal canal. This technique should reduce the failure rate of probing without the need for infracturing of the lower turbinate or silicone intubation.

Adolescent↗
PubMed1991

Canalicular stenosis following probing for congenital nasolacrimal duct obstruction.

A canalicular stenosis was identified in 29 of 66 (44%) children and 35 of 80 (44%) lacrimal drainage systems undergoing silicone intubation for congenital nasolacrimal duct obstruction, having previously had unsuccessful probings. The stenoses were equally divided between boys and girls and between right and left sides. There was no significant difference in age at the time of probing, number of prior probings, or age at intubation between children with and without canalicular stenosis. Stenoses may be congenital or acquired as a result of faulty probing. Any child undergoing a second lacrimal procedure after a failed probing should be evaluated for evidence of a canalicular stenosis. If a stenosis is present, a silicone stent should be placed to try to salvage the canaliculus.

Child, Preschool↗