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Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
Acute dacryocystitis in pediatric patients and frequency of nasolacrimal duct patency
Abdulmajeed Alaboudi1, Osama Al-Shaikh2, Dalal Fatani3
1Department of Ophthalmology, College of Medicine, Al Qassim University , Riyadh, Saudi Arabia.
Insights
Acute dacryocystitis in children is often linked to congenital nasolacrimal duct obstruction (NLDO). Early recognition and treatment of pediatric acute dacryocystitis are crucial for optimal outcomes.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Clinical Research
Background:
- Acute dacryocystitis is a common eye infection in children.
- Understanding its pediatric presentation and risk factors is essential for effective management.
Purpose of the Study:
- To investigate the demographic profiles, clinical presentations, and management outcomes of acute dacryocystitis in pediatric patients.
- To identify key risk factors associated with acute dacryocystitis in this age group.
Main Methods:
- A retrospective case series analysis of 51 pediatric patients (0-17 years) diagnosed with acute dacryocystitis.
- Data collected included demographics, risk factors, clinical presentation, management strategies, and treatment outcomes.
Main Results:
- Congenital nasolacrimal duct obstruction (NLDO) was identified as the primary risk factor in 74.5% of cases.
- Complications such as orbital cellulitis (7.8%) and lacrimal sac fistula (5.8%) were observed.
- Systemic antibiotics were the initial treatment for all patients, followed by surgical interventions like probing (49%) and dacryocystorhinostomy (DCR) (23.5%) in some cases.
Conclusions:
- Prompt diagnosis and urgent management of pediatric acute dacryocystitis are vital to prevent complications.
- Congenital NLDO is the predominant risk factor, but acute dacryocystitis can occur even with a patent lacrimal system.
Abstract:
Purpose: To study acute dacryocystitis in a pediatric age group, focusing on patients' demographic profiles, clinical presentation, and management outcome. Methods: A retrospective case series of all acute dacryocystitis in pediatric patients (0-17 years) from two tertiary-care eye centres in Riyadh, Saudi Arabia was conducted. Demographic profile, risk factors, initial clinical presentation, management regimens, and final outcome were analysed. Results: A total of 51 patients were included in the study. The mean age of presentation was 3.9 ± 4 years (1 month-13 years). Thirty-eight patients (74.5%) reported symptoms of congenital nasolacrimal duct obstruction (NLDO) prior to presentation, four patients (7.8%) had congenital dacryocystocele, two (3.9%) had a history of traumatic NLDO, and ten (19.6%) had an attack of acute dacryocystitis in the absence of NLDO or any other known risk factors. Four patients (7.8%) progressed to orbital cellulitis while another three (5.8%) had lacrimal sac fistula secondary to acute dacryocystitis. Systemic antibiotics were the initial management in all 51 patients. Twenty-five (49%) underwent probing after the resolution of the acute attack while 12 (23.5%) patients underwent dacryocystorhinostomy (DCR). Conclusions: Early recognition and urgent management for acute dacryocystitis are required to prevent further potential complications and achieve excellent outcomes. Congenital NLDO is the main risk factor for the development of acute dacryocystitis in the pediatric age group. In a small set of patients, acute dacryocystitis can develop despite the presence of a patent lacrimal drainage system on clinical evaluation with lack of tearing and discharge before and after the attack of acute dacryocystitis.
