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2013 Month : March Volume : 2 Issue : 9 Page : 1050-1087

EVALUATION OF CONSERVATIVE MANAGEMENT OF CONGENITAL NASOLACRIMAL DUCT OBSTRUCTION IN INFANTS BETWEEN 2WKS TO 11 MONTHS AGE.

P. Sudhir Babu, Arvind Ram, G. Amaresh

CORRESPONDING AUTHOR
Dr .P. Sudhir Babu,
Associate Professor, Dept of Ophthalmology,
Kamineni Institute of Medical Sciences,
Narketpally,  Nalagonda dist Andhra Pradesh,
E-mail: spadgul@gmail.com
Ph: 0091 9701896996

ABSTR ACT:  BACKGROUND: Congenital nasolacrimal duct obstruction is a condition with non canalisation of the membranous part of the duct at the level of valve of Hasner and occurs in 5-6% of infants, Nasolacrimal duct massaging is a standard procedure which increases the hydrostatic pressure in the canal thus widening and opening the canal at the level of valve of Hasner. STUDY DESIGN: This was a prospective study conducted to determine the efficacy of nasolacrimal duct massaging in infants with congenital nasolacrimal duct obstruction. Infants presenting with discharge and duct obstruction were included in the study. Parents were demonstrated and made to do the nasolacrimal duct massaging. All cases were reviewed at 4th, 6th, 8th, 12th, 16th weeks and changes in the symptoms were recorded. Time at which there was no discharge was considered to be cured. RESULTS: Out of 57 cases, 35(61.40%) were males and 22(38.59%) were females.  11 cases had bilateral presentation and 46 eyes   had unilateral presentation (26 RE,20 LE). Mean and standard deviation of age of presentation was 2 months 27 days (87.127± 41.147days). Median age of presentation was 95 days and Mode was 115 days.  Mucoid discharge 24(42.10%)and mucopurulent discharge 20 (35.08%)  were the most common presenting symptoms. 52.63% were referred by Paediatric department. Out of 57 cases 50 (87.71%) responded to NLD massaging, 5(8.77%) cases responded to probing. 2 cases were referred to oculoplasty surgeon. Success rate of Combined nasolacrimal duct obstruction massaging and probing was 96.49% CONCLUSION: With this study we conclude that, conservative management of cases with congenital nasolacrimal duct obstruction has good results when in early infancy. Proper education of parents or relatives and proper understanding of the massaging process is must.
KEY WORDS: Congenital, Nasolacrimal duct, Massaging, Probing.

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