Pediatric canaliculitis and stone formation

Area of Science:

• Ophthalmology
• Pediatric Otolaryngology

Background:

• Nasolacrimal duct obstruction (NLDO) is common in children, often resolving with conservative management.
• Idiopathic thrombocytopenic purpura (ITP) is an autoimmune condition affecting platelet counts.
• Partial NLDO unresponsive to standard treatments warrants further investigation.

Observation:

• A 5-year-old girl with a history of ITP presented with persistent partial NLDO.
• Previous treatments including probing, irrigation, and intubation failed to resolve the obstruction.
• Surgical exploration identified canaliculitis with dacryolith formation in the inferior canalicular system.

Findings:

• Canaliculitis with dacryoliths, though rare in children, was the cause of obstruction.
• Surgical intervention involving punctoplasty and dacryolith removal led to complete symptom resolution.
• Histopathological examination confirmed the presence of dacryoliths.

Implications:

• This case underscores the necessity of including canaliculitis and dacryolith formation in the differential diagnosis for chronic or recurrent pediatric NLDO.
• Early surgical intervention can be effective in resolving complex cases of pediatric NLDO.
• Further research may elucidate the underlying mechanisms contributing to dacryolith formation in pediatric patients.