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Nasolacrimal Duct Obstruction
What is NLDO?
Congenital Nasolacrimal Duct Obstruction (CNLDO) is also referred to as a blocked tear duct. It can lead to excessive tearing in your newborn infant that is noted around 6-8 weeks of life. The eyelashes will appear matted together, there will be both tears and mucous which could often be confused for an eye infection. Patients will most likely be evaluated and diagnosed by their pediatrician prior to a visit with an ophthalmologist.
What causes NLDO?
The cause of the obstruction is often a mucosal valve at the end of the lacrimal system which when open, drains the tears into the nasal cavity.
When should I be worried?
Having the tears stagnant and undrained, may promote bacterial growth that leads to an ocular infections. In such a case, the white of the eye will be red and there may be discolored discharge. There may also be reddening and elevation of the periocular skin between the eye and nose.
When is surgery necessary?
More often than not, the mucosal valve spontaneously opens within the first year of life which would be noted by a cessation in excessive tearing symptoms. If there is no spontaneous resolution by 12 months of age, it is time to consider surgical options.
What happens during surgery and what can I expect?
NLD probing is an outpatient procedure that we perform at an ambulatory surgery center and is considered a medical necessity that is covered by medical insurance. Your child will undergo general anesthesia and will be asleep during the procedure. The lacrimal system opening will be dilated at the inner eyelid margin. The system will then be probed to open the distal mucosal valve. Next, a silicone stent will be placed in the area to prevent scar tissue from closing the newly formed opening. Improvement can usually be seen within days to weeks. The stent is left in placed for 3-6 months and can be removed in the clinic with ease.