What is congenital obstruction of the lacrimal duct (Dacryostenosis)?

Today my patient was a beautiful 4-month-old baby; His mother took him to see me, worried about the constant tearing that she has noticed in her son’s right eye for about 3 months.

Then we comment on Dacryostenosis, which is the obstruction or stenosis of the nasolacrimal duct present from birth and that produces excessive tearing.

This is the most common lacrimal system disease in children. It is produced by a failure in the channeling of the lacrimal duct at the level of the Hasner valve. And it can be unilateral or bilateral; children may present tearing, irritation, inflammation, pain and recurrent infections (Dacryocystitis).

Its diagnosis is in the ophthalmologist’s office through a complete questioning and a review of the anterior segment, in which, for example, fluorescein can be used to measure the tear meniscus (it measures what is not absorbed from the tear), among others. Indeed, my patient had all these characteristics and also an enlarged tear meniscus.

Regarding treatment, until the first year of age, massages are recommended. These are done gently by sliding our finger from the lacrimal area to the nose area, several times a day; Later, clean the area and if the ophthalmologist considers it necessary, a drop of antibiotic is placed.

Most cases resolve spontaneously before the first year of age. If this does not happen, probing and irrigation of the lacrimal duct can be performed. After 2 failed probes, silicone tube placement is performed. Dacryocystorhinostomy is for children older than 2 years without improvement after probing and intubation.

For my patient we start with general measures (massage and grooming) and later he will have a subsequent appointment for review.