Lacrimal Obstructions



Lacrimal Obstructions





CONGENITAL OBSTRUCTIONS


CONGENITAL NASOLACRIMAL DUCT OBSTRUCTION

Congenital nasolacrimal duct obstruction is seen in 2% to 6% of newborns but resolves in the first 3 to 4 weeks in most infants. The chronic purulent discharge is the main problem for caregivers, but, with additional time, a large percentage of these obstructions will resolve on their own.


Epidemiology and Etiology

• Age: Congenital

• Gender: Equal in males and females

• Etiology: Incomplete development of the distal lacrimal passage with a membranous block at the valve of Hasner


History

• Parents will note a chronic mucous discharge with matting of the eyelashes at 3 to 4 weeks of age in 2% to 6% of full-term infants in one or both of the eyes.

• Most obstructions will spontaneously resolve by the age of 6 to 12 months.



Differential Diagnosis

• Chronic conjunctivitis

• Punctal dysgenesis

• Entropion

• Trichiasis



Prognosis

• Treatment is very successful. Waiting for spontaneous resolution while the child has chronic discharge is often difficult for the caregivers.



DACRYOCYSTOCELE

Adacryocystocele is a rare lesion noted at birth in the medial canthal area. It represents fluid and mucus trapped in the lacrimal sac. Dacryocystoceles will resolve but must be observed carefully because they can become infected.


Epidemiology and Etiology

• Age: Congenital

• Gender: Equal in males and females

• Etiology: Blockage of the lacrimal system distally, at the valve of Hasner, and proximally, at the valve of Rosenmüller, resulting in trapped amniotic fluid and/or mucus produced by the lacrimal sac goblet cells


History

• Cystic swelling of the medial canthus below the tendon noted at birth

May 4, 2019 | Posted by in OPHTHALMOLOGY | Comments Off on Lacrimal Obstructions

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