Related Experiment Video
Updated: Jun 21, 2026
Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
Management of congenital nasolacrimal duct obstruction
Yasuhiro Takahashi1, Hirohiko Kakizaki, Weng O Chan
1Department of Ophthalmology and Visual Sciences, Osaka City University Graduate School of Medicine, Osaka, Japan.
Insights
Congenital nasolacrimal duct obstruction (CNDO) management favors a watchful approach with conservative therapies for infants under one year. Persistent CNDO beyond one year warrants probing, with advanced treatments for failed cases.
Area of Science:
- Ophthalmology
- Pediatric Otolaryngology
Background:
- Congenital nasolacrimal duct obstruction (CNDO) is a common condition in infants.
- Traditional management often involved early surgical intervention.
Purpose of the Study:
- To update management protocols for congenital nasolacrimal duct obstruction.
- To evaluate the efficacy of conservative versus interventional approaches based on age.
Main Methods:
- Review of current literature and management guidelines for CNDO.
- Analysis of spontaneous resolution rates and treatment success based on age.
Main Results:
- High rates of spontaneous resolution occur in infants under one year of age.
- Probing is recommended as a first-line therapy for persistent CNDO beyond one year.
- Success rates of probing decrease with advancing age.
Conclusions:
- A 'wait-and-see' approach with conservative therapies is optimal for infants <1 year with CNDO.
- Persistent CNDO after age one necessitates probing, with timing balanced against decreasing success rates.
- Advanced interventions like balloon dilation or intubation are options for refractory cases.
Abstract:
Our review aims to provide an update of management protocols for congenital nasolacrimal duct obstruction (CNDO). Although early probing performed before the age of 1 year was traditionally recommended, many reports have since confirmed high frequencies of spontaneous resolution during the first year of life. Accordingly, a 'wait-and-see' approach, combined with conservative therapies, is judged to be the best option in infants aged<1 year. By contrast, persistent obstruction beyond 1 year of age warrants probing as a first-line interventional therapy. However, the optimal timing for probing remains controversial. Although there remains a high possibility of spontaneous resolution after the first year of age, this must be balanced against the decrease in success rates for probing that accompanies advancing age. If conservative management fails, persistent CNDO beyond 1 year of age should be managed either by further observation or by primary probing according to the severity of symptoms. In patients in whom probing fails, advanced treatment such as balloon catheter dilation, silicone tube intubation or dacryocystorhinostomy may be considered.
Related Concept Videos
01:29Suctioning the Nasopharyngeal Airway
Equipment Required
01:28Angle Closure Glaucoma: Treatment
01:30Epistaxis
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
01:25Suctioning the Oropharyngeal Airway
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...