Nasolacrimal Duct Obstruction

What is 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 might help some of the symptoms, BUT this is not cure for the blockage. Such obstructions might 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 might be necessary.

The very end of the duct is the most common place for a blockage to occur. This site is called the valve of Hasner at the distal nasolacrimal duct and might represent failure of canalization of the epithelial cells that form the duct. Many of these do open on their own given time. Massaging the tear sac may help create a pressure wave that can open the blockage.

Blockage presents in one of four ways:

Simple obstruction

Congenital fistula

Acute Dacryocystitis

Congenital Dacryocele or Mucocele

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