OPHTHALMIC CONDITIONS
Nasolacrimal Duct Obstruction
When there is an obstruction in the tear drainage pathway and tears pool and overflow from the eye
What exactly is nasolacrimal duct obstruction?
The normal drainage of tears is achieved through small openings, called lacrimal puncta. Tears travel through the lacrimal canals, into the lacrimal sac, and finally into the nasolacrimal duct. When there is an obstruction in the tear drainage pathway, then tears can pool (overflow) in the eye (epiphora or watery eyes). This phenomenon often leads to local infections and mucous secretions.
The stagnation of tears can cause an infection of the lacrimal sac (dacryocystitis). Nasolacrimal duct obstruction can be either congenital or acquired. About 5% of infants show symptoms of nasolacrimal duct obstruction in one or both eyes. In a large percentage of cases, it resolves spontaneously within the first year of life.
What are the main symptoms of nasolacrimal duct obstruction?
The most common complaint among patients with nasolacrimal duct obstruction is tear overflow (epiphora). Pain with swelling on the side of the nose and on the lower eyelid indicate the presence of dacryocystitis, an extremely challenging and painful eye condition. Additionally, symptoms for patients with nasolacrimal duct obstruction may include sticky eyelashes, significant purulent discharge, and irritated, swollen, or red eyelids.
What are the primary causes of nasolacrimal duct obstruction?
The main causes of nasolacrimal duct obstruction include:
Absence of lacrimal puncta
Narrowing of the tear ducts
Infection
Inflammation in the tear drainage system
Sinus disease
How can nasolacrimal duct obstruction be treated?
Persistent cases of nasolacrimal duct obstruction are treated as follows:
Localized massage of the affected area
Topical antibiotic drops
Nasolacrimal duct catheterization: a thin catheter is carefully inserted into the nose through the natural path of the nasolacrimal duct to widen it
Insertion of silicone stents to maintain the patency of the nasolacrimal duct
Surgical procedures such as dacryocystorhinostomy or dacryocystostomy (DCR) in severe cases (serious dacryocystitis)
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