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Lacrimal and nasal masquerades of congenital nasolacrimal duct obstructions: etiology, management, and outcomes.
Int Ophthalmol 2015; 35(6):807-10IO

Abstract

The purpose of this study was to report various conditions masquerading as congenital nasolacrimal duct obstruction (CNLDO). Retrospective review was designed in a tertiary hospital setting. 92 eyes of 65 consecutive patients were included in this study. All patients presenting with CNLDO symptomatology but where the diagnosis of CNLDO was subsequently ruled out were included in the study. The study patients were recruited from a single surgeon's (MJA) tertiary eye care practice over a 3-year period from 2011 to 2013. A detailed clinical evaluation and a further lacrimal system evaluation were performed under general anesthesia. The main outcome measure was other lacrimal and nasal conditions masquerading as CNLDO. Average age at presentation was 43.49 ± 31.78 months. All cases had symptoms of either watering or discharge with an increase tear meniscus or abnormal fluorescein dye disappearance test. The commonest masquerades of congenital nasolacrimal duct obstruction include incomplete punctal canalisation (27.2 %), functional epiphora (14.1 %), punctal agenesis (14.1 %), monocanalicular obstructions (10.8 %), and presaccal stenosis (8.7 %). Each masquerade was managed specifically and at the last follow-up of 5.85 ± 10.85 months, 63 % eyes (58/92) had no epiphora and 2.2 % (2/92) eyes had occasional epiphora. Parents of patients with punctal agenesis were counseled for option of conjunctivodacryocystorhinostomy in future. Incomplete punctal canalisation is the commonest masquerade among many conditions that may mimic CNLDO and mandates a careful evaluation. Specific management of each masquerade results in satisfactory outcomes.

Authors+Show Affiliations

Dacryology Service, L.V. Prasad Eye Institute, Road No 2, Banjara Hills, P.O. Box 34, Hyderabad, India.Dacryology Service, L.V. Prasad Eye Institute, Road No 2, Banjara Hills, P.O. Box 34, Hyderabad, India. drjaved007@gmail.com.Dacryology Service, L.V. Prasad Eye Institute, Road No 2, Banjara Hills, P.O. Box 34, Hyderabad, India.Dacryology Service, L.V. Prasad Eye Institute, Road No 2, Banjara Hills, P.O. Box 34, Hyderabad, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25680420

Citation

Kamal, Saurabh, et al. "Lacrimal and Nasal Masquerades of Congenital Nasolacrimal Duct Obstructions: Etiology, Management, and Outcomes." International Ophthalmology, vol. 35, no. 6, 2015, pp. 807-10.
Kamal S, Ali MJ, Gupta A, et al. Lacrimal and nasal masquerades of congenital nasolacrimal duct obstructions: etiology, management, and outcomes. Int Ophthalmol. 2015;35(6):807-10.
Kamal, S., Ali, M. J., Gupta, A., & Naik, M. N. (2015). Lacrimal and nasal masquerades of congenital nasolacrimal duct obstructions: etiology, management, and outcomes. International Ophthalmology, 35(6), pp. 807-10. doi:10.1007/s10792-015-0050-1.
Kamal S, et al. Lacrimal and Nasal Masquerades of Congenital Nasolacrimal Duct Obstructions: Etiology, Management, and Outcomes. Int Ophthalmol. 2015;35(6):807-10. PubMed PMID: 25680420.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lacrimal and nasal masquerades of congenital nasolacrimal duct obstructions: etiology, management, and outcomes. AU - Kamal,Saurabh, AU - Ali,Mohammad Javed, AU - Gupta,Adit, AU - Naik,Milind N, Y1 - 2015/02/14/ PY - 2014/11/14/received PY - 2015/02/09/accepted PY - 2015/2/15/entrez PY - 2015/2/15/pubmed PY - 2016/6/24/medline KW - CNLDO KW - Congenital nasolacrimal duct obstruction KW - Functional epiphora KW - Incomplete punctal canalization KW - Presaccal stenosis SP - 807 EP - 10 JF - International ophthalmology JO - Int Ophthalmol VL - 35 IS - 6 N2 - The purpose of this study was to report various conditions masquerading as congenital nasolacrimal duct obstruction (CNLDO). Retrospective review was designed in a tertiary hospital setting. 92 eyes of 65 consecutive patients were included in this study. All patients presenting with CNLDO symptomatology but where the diagnosis of CNLDO was subsequently ruled out were included in the study. The study patients were recruited from a single surgeon's (MJA) tertiary eye care practice over a 3-year period from 2011 to 2013. A detailed clinical evaluation and a further lacrimal system evaluation were performed under general anesthesia. The main outcome measure was other lacrimal and nasal conditions masquerading as CNLDO. Average age at presentation was 43.49 ± 31.78 months. All cases had symptoms of either watering or discharge with an increase tear meniscus or abnormal fluorescein dye disappearance test. The commonest masquerades of congenital nasolacrimal duct obstruction include incomplete punctal canalisation (27.2 %), functional epiphora (14.1 %), punctal agenesis (14.1 %), monocanalicular obstructions (10.8 %), and presaccal stenosis (8.7 %). Each masquerade was managed specifically and at the last follow-up of 5.85 ± 10.85 months, 63 % eyes (58/92) had no epiphora and 2.2 % (2/92) eyes had occasional epiphora. Parents of patients with punctal agenesis were counseled for option of conjunctivodacryocystorhinostomy in future. Incomplete punctal canalisation is the commonest masquerade among many conditions that may mimic CNLDO and mandates a careful evaluation. Specific management of each masquerade results in satisfactory outcomes. SN - 1573-2630 UR - https://www.unboundmedicine.com/medline/citation/25680420/Lacrimal_and_nasal_masquerades_of_congenital_nasolacrimal_duct_obstructions:_etiology_management_and_outcomes_ L2 - https://doi.org/10.1007/s10792-015-0050-1 DB - PRIME DP - Unbound Medicine ER -