Naso-Lacrymal Duct Obstruction is a condition in which a newborn infant has a tear sac with a delayed opening, causing obstruction to normal tear flow. This condition affects one out of five newborns, and results in an infected eye on one or both sides. Within three months, 80% have opened spontaneously. By six months of age, another 10% clear up, and by nine months of age, another 5% have cleared up, leaving about 5% that need to have a procedure to open the duct.
- Office Probe: In our office, we swaddle the child in a sheet for restraint. Then, we place an anesthetic drop in the eye to numb the cornea, but it does not numb the lid. Then, we open the punctum on the lid margin with a small dilator. We pass an irrigating probe down the naso-lacrymal canal, penetrate the membrane, and irrigate some saline to insure that the canal is open. The procedure takes about three to six minutes. 90% of the time, there is blood staining of the tears and/or nasal secretions, lasting just a few minutes. This is normal, and there is no after-pain. Parents should continue an antibiotic eye drop three times a day for about five days. There is only about a 5% failure rate for this procedure.
- Tube Placement at Hospital: In symptoms return, and the patient is over nine months old, we will recommend the placement of a tube under general anesthesia at the hospital. The tube is left in place for six months, and then removed in our offices. This procedure has a 99% success rate. At the time of surgery, we also check the inferior turbinates in the nose. If they are crowding the inferior meatus, it is an easy matter to infracture them.
Of course, we will discuss your treatment options and describe our procedures in-depth as they relate to your child's particular condition. We understand the level of anxiety parents have when it comes to medical conditions with their newborn child. We make every effort to ensure that you and your child are as comfortable as possible with these procedures.
Your ophthalmologist at Fort Worth Eye Associates can provide you with more information specific to your case. The above information is not intended to replace a personal exam, medical diagnosis, and/or complete treatment description by an ophthalmologist.