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