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Lacrimal Duct Obstruction, Pediatric

Bethlehem Abebe-Wolpaw, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

A congenital blockage identified in infants from failure of canalization, most commonly at the distal portion, of the nasolacrimal duct. Epiphora (constant tearing) is the most commo...

DIAGNOSIS

HISTORY

  • Congenital obstruction presents in first few weeks of life once tear production matures usually by 6 weeks after birth.

  • Frequency and duration

  • Symptoms can be either unilateral or bilat...

TREATMENT

GENERAL MEASURES

  • Primary treatment for congenital obstruction is lacrimal sac massage or compression in a downward fashion (Crigler maneuver).

  • Encourage parents to massage. This may increase t...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Conservative measures are appropriate for infants with congenital obstruction, although at 6 to 12 months of age, referral to ophthalmology shou...

ADDITIONAL READING

  • Kamal S, Ali MJ, Gupta A, et al. Lacrimal and nasal masquerades of congenital nasolacrimal duct obstructions: etiology, management, and outcomes. Int Ophthalmol.  2015;35(6):80...

CODES

ICD9

  • 375.56 Stenosis of nasolacrimal duct, acquired

  • 375.55 Obstruction of nasolacrimal duct, neonatal

  • 743.65 Specified congenital anomalies of lacrimal passages

  • 375.22 Epiphora due to insufficient d...

FAQ

  • Q: Why not fix the obstruction upon diagnosis?

  • A: Studies have shown that about 90% of cases of congenital obstruction resolve by 12 months of age using conservative measures consisting of massage ...

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