Nasolacrimal duct issues

Obstruction (click here for discussion)

• Common (5% of infants)
• Obstruction occurs at the distal end
• No associated conjunctival inflammation, photophobia, or corneal clouding.
• Course: 95% resolve by 13 months of age
• Treatment: Digital massage 2-3x/day; Nasolacrimal duct probing if persistent after 13 months of age
• Glaucoma, congenital: epiphora (tearing) is a sign of glaucoma (will see rhinorrhea)... ddx obstruction of the nasolacrimal duct, which has NO rhinorrhea
   

Infection (Dacrocystitis)

• Bacterial infection of the lacrimal sac
• Manifested by edema, erythema and tenderness
• Treatment: Systemic antibiotics

CHLA Board Review 2005