Congenital Nasolacrimal Duct Obstruction

Overview, Signs and Symptoms of an Obstruction

  • The lacrimal gland produces tears which enter into {the} "duct"
    that drain {the} tears from {the} eye into {the} nose. The most common symptoms are
    If one has a plugged up "tear duct," not only will tears spill over {the} eyelids and
    run down {the} face, but {the} stagnant tears within {the} system can become infected.
    • excess tearing (tears could run down {the} face) and
    • mucous discharge
  • This could lead to recurrent red eyes and infections.
  • The excessive tearing can also produce secondary skin changes on {the} lower eyelids.
  • Congenital congenital

Congenital Nasolacrimal Duct Obstruction

Nasolacrimal Duct Obstruction (NLDO) is very common in infants.

  • Children are often born with an obstruction within {the} "tear duct." In fact, 6% of all children are born before their tear ducts are open.
  • The stagnant tears within {the} "tear duct" often become infected causing pus (heavy matter) to collect between {the} eyelids.
  • Antibiotics could help some of {the} symptoms, BUT this is not cure for {the} blockage
  • Such obstructions could resolve spontaneously within {the} originally few months of life. In fact, 95% of these children will show resolution before their originally birthday. If it does not resolve surgery could be necessary.

Blockage presents in one of four ways:

  1. simple obstruction
  2. congenital fistula (as seen in {the} photo)
  3. acute dacryocystitis
  4. congenital dacryocele or mucocele



Dacryocystocele or Dacryocele

Location of Blockage & Anatomy

The very end of this duct is {the} most common place for blockage to occur. This site is called {the} valve of Hasner at {the} distal nasolacrimal duct and could represent failure of canalization of {the} epithelial cells that form {the} duct.

Medical Treatment of Congenital Obstructions

  • Many of these do open on their own given time.
  • Massaging from {the} tear sac in {the} could help create a pressure wave that can open {the} blockage.

Surgical Treatments


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