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Watery eyes (blocked tear ducts/CNLDO) in children

Watery eyes (blocked tear ducts/CNLDO) in children

Watering from the eyes of a child is most commonly caused due to blockage of nasolacrimal duct that drain tears from the eye to the nose.

The red dot in the image on the left shows the common area where the block is usually found.

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The child would present with

This can be confirmed by applying green colored dye (Fluorescin) that gets retained in the eye and doesnot get drained in the duct.

Watering from left eye demonstrated by DD test

Fluorescein dye diappearance test showing retention

Mucocele on left side

Mucocele on both sides

Fistula in right eye

Fistula in left eye

Dye leakage from fistula

Treatment

Nearly 90-95 % children have complete resolution with Antibiotic eye drops and lacrimal massage within 1 year of age.

If this condition is not resolved beyond 1 year of age it can cause infections that can spread into the eye or into the brain

Antibiotic eye drops and lacrimal massage may help to cure the disease if performed within 1 year of age.

Watch technique for lacrimal massage here. https://www.youtube.com/watch?v=bVD3NYEBTCo

For children more than 1 year, 3 surgical procedures are available:

  • Simple Probing: Probing is a very safe, effective and short procedure that can easily open up the blocked ducts in 1-2 mintues
  • Probing with infracture / silastic tubes: For patients who had one failed probing or older children >4 years or children with Down’s syndrome, simple probing procedure does not cure the condition with high success. At Jyotirmay eye clinic, we possess special equipment (Ritleng intubation / Crawford intubation with retriever / Pediatric Nasal endoscope / Smart probes etc) to cure this condition with 70-80% success rate. This procedure can avoid a major surgery in those patients.
  • Dacryo cysto rhinostomy: A child with bony block or older children (>6 years) are the best candidate for this procedure.

1. Left eye Congenital Nasolacrimal Duct obstruction causing watering from the eye before Probing surgery

2. Resolution of symptoms after surgery (probing)

What is special atJyotirmay Eye Clinic?

  • We use smart lacrimal probes invented by us that increase the success and reduce the bleeding
  • We use Sevoflurane anesthesia to perform the entire surgery within a couple of minutes
  • We use Nasal Endoscope to ensure near 100% success rates

Watch Videos of Smart Probe for Smarter Probing

Balloon Dacryocystoplasty

This is a novel method to treat complex nasolacrimal duct obstruction or CNLDO in older children >6 years with or without silicone intubation. The procedure is simple and the overall success rate is 70%. If combined with silicon intubation the success rate increases to 90%.

To watch the video – click below https://www.youtube.com/watch?v=TXZjYfwG37E

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